[A case of pulmonary coccidioidomycosis presented with bilateral infiltrative opacities and eosinophilia].
A 53-year-old male was admitted to our hospital complaining of high fever with chillness, cough and dyspnea after traveling to Arizona in the United States. The chest X-ray films taken on admission showed consolidation in the right middle lung field and bilateral nodular shadows. The laboratory data revealed an increase in white blood cell counts with eosinophilia, and a rise in erythrocyte sediment rate and serum C-reactive protein. The biopsied lung specimen by video-assisted thoracoscopic surgery showed granulomatous inflammation consisting of eosinophils and giant cells. In addition, typical spherules filled with endopores were detected in the specimen. The diagnosis of primary pulmonary coccidioidomycosis was made. After the treatment of a three months' regimen with itraconazole at the daily dosage of 200 mg, the patient's symptoms, laboratory data and radiological findings markedly improved.
Department of Respiratory Medicine, Toranomon Hospital.
Masateru
M
Kawabata
Sakae
S
Homma
Susumu
S
Sakamoto
Kazuma
K
Kishi
Eiyasu
E
Tsuboi
Koichiro
K
Nakata
Kunihiko
K
Yoshimura
D001130:Arizona; D001706:Biopsy / Q000379:methods; D003047:Coccidioidomycosis / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008168:Lung / Q000473:pathology*; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011657:Pulmonary Eosinophilia / Q000150:complications*; D013902:Radiography, Thoracic; D020775:Thoracic Surgery, Video-Assisted; D014195:Travel