title: Phenotypic and molecular identification of Coccidioides posadasii in a patient evaluated for bilateral lung transplantation.
abstract: BACKGROUND
  Coccidioidomycosis is an endemic fungal infection caused by Coccidioides immitis and Coccidioides posadasii. It can be particularly severe in transplant recipients that have a current or a previous coccidioidal infection. Fatal case of coccidioidomycosis has been described in this group of patients.
  
  
  OBJECTIVE
  We report a severe case of pneumonia caused by C. posadassi in a 29 year-old white woman that had been admitted to hospital as part of the evaluation for bilateral lung transplantation. The patient was a native and resident of Catamarca, Argentina. Molecular methodologies contributed to the species identification.
  
  
  METHODS
  Clinical, laboratory records and microbiological tests were carried out to diagnose the infection and to identify C. posadasii.
  
  
  RESULTS
  A fungus was isolated from BAL culture. Phenotypic characterization, specific PCR and experimental animal inoculation demonstrated the presence of C. posadasii. The patient responded well to amphotericin B deoxycholate. Lung transplantation was postponed.
  
  
  CONCLUSIONS
  Specific PCR can be an important alternative for the correct identification of C. immitis or C. posadasii in laboratories with implemented molecular biology tools. This case emphasizes the need for a systematic assessment in organ transplant units of patients inhabiting endemic areas of coccidioidomycosis.
authors.affiliation: Hospital Universitario Fundación Favaloro, Laboratorio Central Servicio de Microbiología, Argentina.
authors.forename: Analía
authors.initials: A
authors.lastname: Fernandez
authors.forename: Fernanda
authors.initials: F
authors.lastname: Landaburu
authors.forename: Gabriela
authors.initials: G
authors.lastname: Lopez-Daneri
authors.forename: Claudia
authors.initials: C
authors.lastname: Nagel
authors.forename: Patricia
authors.initials: P
authors.lastname: Di Giorgio
authors.forename: Cristina
authors.initials: C
authors.lastname: Iovannitti
authors.forename: Marta
authors.initials: M
authors.lastname: Tokumoto
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Mujica
mesh_terms: D000328:Adult; D003045:Coccidioides / Q000235:genetics* / Q000302:isolation & purification*; D003047:Coccidioidomycosis / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000382:microbiology; D016040:Lung Transplantation; D010641:Phenotype