title: A case of fever, eosinophilia, and pneumonia.
abstract: There is a broad differential for patients presenting with fever, eosinophilia, and pneumonia. We present a case of a 48-year-old man who presented with recurrent fever, pleuritic chest pain, and cough. His medical history was significant for a recent trip to Arizona. A chest X ray showed a right lower lobe infiltrate and CT examination of the chest showed extensive mediastinal lymphadenopathy. Tissue culture from a biopsy specimen of the mediastinal lymph nodes revealed growth of Coccidioides immitis and a diagnosis of coccidioidomycosis was made. He was treated with a total of a 9-month course of itraconazole and has remained disease free for >2 years. This case shows how a careful history and evaluation will direct the clinician to the correct diagnosis.
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Department of Medicine, New Jersey Medical School, Newark, USA.
authors.forename: Carla M
authors.initials: CM
authors.lastname: Ward
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Zuromskis
authors.forename: David V
authors.initials: DV
authors.lastname: Ives
authors.forename: Javed
authors.initials: J
authors.lastname: Sheikh
mesh_terms: D003047:Coccidioidomycosis / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D004802:Eosinophilia; D005334:Fever; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000175:diagnosis; D008875:Middle Aged; D011014:Pneumonia