title: Unusual case of pyopneumothorax in Tennessee.
abstract: Rupture of a coccidioidal pulmonary cavity with subsequent pyopneumothorax is a rare clinical event, even in areas endemic for coccidioidomycosis. Our encounter with a patient diagnosed with this condition in northeast Tennessee serves notice to clinicians that coccidioidomycosis is indeed a traveling fungal disease, and practitioners must be alert to common and uncommon manifestations of infection associated with this fungus. A literature review pertaining to coccidioidal pyopneumothorax revealed that patients usually present with a recent onset of chest pain. Serologic testing and pleural fluid culture are highly useful, and management includes surgical intervention with or without antifungal therapy.
authors.affiliation: James H. Quillen Veterans Affairs Medical Center and James H. Quillen College of Medicine, Johnson City, TN, USA.
authors.forename: Souad S
authors.initials: SS
authors.lastname: Youssef
authors.forename: Vijay
authors.initials: V
authors.lastname: Ramu
authors.forename: Felix A
authors.initials: FA
authors.lastname: Sarubbi
mesh_terms: D000368:Aged; D003047:Coccidioidomycosis / Q000175:diagnosis* / Q000453:epidemiology; D016724:Empyema, Pleural / Q000175:diagnosis* / Q000382:microbiology; D006801:Humans; D006872:Hydropneumothorax / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D011030:Pneumothorax / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D015206:Southwestern United States / Q000453:epidemiology; D013714:Tennessee / Q000453:epidemiology; D014195:Travel