Document Detail

Disseminated coccidioidomycosis with lung, skin and lymph node involvement: report of a case.
MedLine Citation:
PMID:  1683374     Owner:  NLM     Status:  MEDLINE    
Coccidioidomycosis is a deep mycotic infection endemic to the southwestern United States. Although it has also been reported to occur in nonendemic areas, it has rarely been reported in Taiwan. We report a case of disseminated coccidioidomycosis which is the first such case reported on this island. The 28-year-old male patient developed a nonproductive cough and fever while travelling in Arizona. Chest roentgenogram revealed infiltration of the right lower lung field and enlargement of the right paratracheal lymph nodes. The titer for the complement fixation test for coccidioidin was 1:32. The patient was treated with ketoconazole for 3 months with good clinical response. However, submandibular lymphadenopathy and a macular skin lesion were noted one month after discontinuation of treatment. During hospitalization, both pathologic findings from a submandibular lymph node and a scratching smear of the skin lesion contained Coccidioides immites. The patient was put on ketoconazole again for another 6 months. Lesions on chest film were resolved and the coccidioidin complement fixation titer was gradually reduced. The patient received regular follow-up and no evidence of relapse has been seen. In this report, clinical manifestations, diagnostic methods and recent advances in the treatment of coccidioidomycosis are discussed. Because of increasing intercontinental travel and the increasing usage of immunosuppressive agents, we expect that more cases will be found in Taiwan. Keeping this disease in mind when making a differential diagnosis is the best way to make an accurate diagnosis.
C H Chen; J F Shih; Y T Hsu; R P Perng
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of the Formosan Medical Association = Taiwan yi zhi     Volume:  90     ISSN:  0929-6646     ISO Abbreviation:  J. Formos. Med. Assoc.     Publication Date:  1991 Aug 
Date Detail:
Created Date:  1991-12-30     Completed Date:  1991-12-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9214933     Medline TA:  J Formos Med Assoc     Country:  TAIWAN    
Other Details:
Languages:  eng     Pagination:  788-92     Citation Subset:  IM    
Department Veterans General Hospital-Taipei, Taiwan R.O.C.
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MeSH Terms
Coccidioidomycosis / complications*,  drug therapy,  epidemiology
Combined Modality Therapy
Dermatomycoses / drug therapy,  microbiology*
Ketoconazole / therapeutic use
Lung Diseases, Fungal / drug therapy,  microbiology*
Lymph Node Excision
Lymphadenitis / drug therapy,  microbiology*
Taiwan / epidemiology
Reg. No./Substance:

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