Pulmonary Coccidioidomycosis: A Case Report and Literature Review

Abstract

Coccidioidomycosis is an infectious disease caused by Coccidioides immitis or C. posadasii fungus. Humans usually get infected by inhaling spores risen from the soil. Although in 60 percent of cases symptoms are absent, remaining patients can develop various manifestations of the disease, from flu-like symptoms to severe dissemination or meningitis. In endemic regions (California, Arizona, Mexico, Central, and South America), pulmonary coccidioidomycosis causes 25% of community-acquired cases of pneumonia. We present the first registered case of pulmonary coccidioidomycosis in Lithuania. Clinical presentation, pathogenesis, treatment options, and diagnostic alternatives are discussed.

Unexpected coccidioidomycosis presenting as lung nodules with presumptive diagnosis of malignancy

“…Definitive diagnosis of coccidioidomycosis relies on careful clinical evaluation and laboratory diagnostic testing. Young age (< 55 years old), absence of past lung diseases, a job in the farming or construction sector, and/or traveling in the endemic regions will raise the possibility of coccidioidomycosis 11 . Microbiological culture, histopathological evaluation, or serological testing should be used to confirm the diagnosis 12 .…”

“…Young age (< 55 years old), absence of past lung diseases, a job in the farming or construction sector, and/ or traveling in the endemic regions will raise the possibility of coccidioidomycosis. 11 Microbiological culture, histopathological evaluation, or serological testing should be used to confirm the diagnosis. 12 Serological assays such as enzyme immunoassay (EIA), immunodiffusion, and complement fixation may be less reliable 3,13,14 and often a biopsy is required to establish the diagnoses via histopathology, culture, and possibly PCR.…”

A Rare Case of Coccidioidomycosis Meningitis

“…Coccidioidomycosis is known as valley fever due to its geographic prevalence of California, Arizona, Mexico, Central, and South America. It is mainly caused by Coccidioides immitis or C. posadasii fungus [ 1 ]. This rare disease is commonly acquired through inhalation of arthroconidia, which is found in dust or soil.…”

“…Once inhaled into the lungs, this fungus will then transform into endospore containing spherules [ 2 ]. It is believed that the affected region is the terminal and respiratory bronchioles, mainly due to the size of the inhaled spores, ranging from 3 to 5 µm [ 1 ]. In the immunocompetent host, a delayed-type hypersensitivity reaction (DTHR) helps control the infection.…”

“…If the fungus is not treated appropriately or is found in an immunocompromised host, coccidioidomycosis can spread to the lungs, brain, and meninges, leading to respiratory failure, sepsis, shock, or even death. One of the more life-threatening forms is when it spreads to the meninges, causing coccidioidomycosis meningitis (CM) [ 1 ]. It affects both immunocompetent and immunocompromised individual, but risk of dissemination is higher in immunocompromised host.…”