Perplexing pericarditis caused by coccidioidomycosis.
In the patient I have described, evaluation of chronic progressive pulmonary coccidioidomycosis presenting itself as cryptogenic pericarditis revealed an unsuspected large endobronchial coccidioidoma. At follow-up after 2 years of fluconazole therapy, the patient was asymptomatic, with a dramatic decrease in infiltrate but no change in CF titers. In endemic areas, coccidioidomycosis should be included in the differential diagnosis of idiopathic pericarditis, especially in high-risk patient populations. Additionally, airway obstruction or compromise might be an early finding in chronic coccidial disease.
Department of Internal Medicine (Pulmonary Division), Naval Hospital, San Diego, CA 92134-5000.
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Amundson
D000328:Adult; D001982:Bronchial Diseases / Q000382:microbiology; D002908:Chronic Disease; D003045:Coccidioides; D003047:Coccidioidomycosis; D006801:Humans; D008172:Lung Diseases, Fungal / Q000382:microbiology*; D008297:Male; D010493:Pericarditis / Q000382:microbiology*