title: Pulmonary and extrapulmonary coccidioidomycosis: three cases in an endemic area in the state of Ceará, Brazil.
abstract: Coccidioidomycosis, a fungal illness acquired by the inhalation of arthroconidia of Coccidioides sp., was first described in 1894. Coccidioidomycosis is mainly restricted to areas with arid climate, alkaline soil and low rainfall. Consequently, most of the reported cases in Brazil have occurred in the northeastern region. We report three cases of pulmonary coccidioidomycosis occurring between 2005 and 2006 in an endemic area in the state of Ceará, Brazil. The three patients were immunocompetent adult males, hunters of armadillos (Dasypus novemcinctus), with complaints of cough, fever, dyspnea and pleuritic pain. All three patients presented pulmonary involvement, and only one also presented cutaneous lesions. Chest X-rays and CT scans of the patients revealed characteristic coccidioidomycosis lesions. The diagnosis was confirmed by serological testing. All of the patients evolved to cure after antifungal treatment.
authors.affiliation: Universidade Federal do Ceará, Sobral, CE, Brasil.
authors.forename: Ricardo Hideo
authors.initials: RH
authors.lastname: Togashi
authors.forename: Fernando Moreira Batista
authors.initials: FM
authors.lastname: Aguiar
authors.forename: Dalton Barros
authors.initials: DB
authors.lastname: Ferreira
authors.forename: Camille Matos de
authors.initials: CM
authors.lastname: Moura
authors.forename: Monique Teixeira Montezuma
authors.initials: MT
authors.lastname: Sales
authors.forename: Nikaelle Ximenes
authors.initials: NX
authors.lastname: Rios
mesh_terms: D000328:Adult; D001938:Brazil; D003045:Coccidioides / Q000276:immunology / Q000302:isolation & purification; D003047:Coccidioidomycosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003889:Desert Climate; D019353:Endemic Diseases; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D011859:Radiography; D012867:Skin / Q000473:pathology; D055815:Young Adult