title: [A clinical and pathological study of coccidioidomycosis and pregnancy in four Mexican women].
abstract: BACKGROUND
  In northeastern Mexican population prevalence of positive cutaneous reaction to coccidioidin varies from 30 to 49%. Pregnancy is a risk factor for disseminated coccidioidomycosis.
  
  
  OBJECTIVE
  1) To describe the clinical spectrum of coccidioidomycosis in four women who acquired the disease during pregnancy or puerperium. 2) To discuss the autopsy findings. 3) To review the medical literature.
  
  
  METHODS
  From 1983 to 2000, files of the Pathology Department of a reference tertiary hospital in northeastern Mexico were reviewed. Four cases of 4,598 autopsies corresponded to pregnant women with coccidioidomycosis. Clinical and autopsy charts, and the histological material were studied.
  
  
  RESULTS
  Clinical spectrum included a septicemia case with fetal lost, an atypical pneumonia, a chronic meningitis with neuropsychiatric alterations and a patient with hypertensive pregnancy disease with secondary renal insufficiency and repeated episodes of pneumonia. All patients at autopsy showed multiple granulomas with abundant mycotic spherules. Lung involvement included bilateral 2-10 mm nodules.
  
  
  CONCLUSIONS
  In pregnant women of endemic areas or who had traveled to these zones during pregnancy, coccidioidomycosis should be considered in the differential diagnosis of febrile syndrome with pneumonia, specially if it is accompanied of bilateral nodular infiltrates in lung, with or without erythema nodosum or meningitis.
authors.affiliation: Departamento de Patología, Hospital de Especialidades núm. 25, IMSS, Monterrey, NL, México. acald911@hotmail.com
authors.forename: Ana Laura
authors.initials: AL
authors.lastname: Calderón Garcidueñas
authors.forename: Karina
authors.initials: K
authors.lastname: Piña Osuna
authors.forename: Ricardo M
authors.initials: RM
authors.lastname: Cerda Flores
mesh_terms: D000328:Adult; D003047:Coccidioidomycosis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008800:Mexico; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*