title: An unusual cause of a pulmonary opacity in a visitor to the UK.
abstract: A 64-year-old man, resident in Arizona for 3&emsp14;years, presented with a week-long history of a dry cough and 'flu-like symptoms'. He had recently been renovating his house. A chest radiograph showed a left mid-zone opacity. Investigations for lung cancer were performed and he underwent CT-guided biopsy of the lesion. A coccidioidal fungus known to cause 'Valley Fever' was isolated. Treatment with fluconazole led to a complete recovery. This fungal infection is endemic in parts of the USA and Mexico and usually presents with respiratory symptoms. Additional complications include disseminated disease and meningitis.
authors.affiliation: Department of Cardiology, Hillingdon Hospital, Uxbridge, Middlesex, UK.
authors.forename: Beatrice Anne Marie
authors.initials: BA
authors.lastname: Downie
authors.forename: Gareth
authors.initials: G
authors.lastname: Rosser
authors.forename: Catherine Mary
authors.initials: CM
authors.lastname: Atkin
authors.forename: Simon William
authors.initials: SW
authors.lastname: Dubrey
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001130:Arizona / Q000453:epidemiology; D003045:Coccidioides / Q000302:isolation & purification*; D003047:Coccidioidomycosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology; D003371:Cough / Q000382:microbiology*; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000382:microbiology*; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D014195:Travel; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole