title: Coughing and fever after surfing in Central America.
abstract: We report the case of a 19-year-old surfer, returning from Central America, who presented with chronic cough. The X-ray and full blood count, which had been performed in Costa Rica, were without pathology; laboratory parameters showed slightly increased C-reactive protein (59 mg/l). Malaria was excluded by thick smear. Immune serological tests for typhus, paratyphus, brucellosis, rickettsioses, leptospirosis and dengue fever were negative. An ambulant antimicrobial treatment was without any clinical effect. A computer tomography of the thorax showed a solid lesion (30 × 20 mm, middle lobe of the right lung). The patient rejected a bronchoscopic examination. He decided to be treated after his return to Austria. Here, we could substantiate a pulmonal histoplasmosis by a positive immune diffusion test. The patient was successfully treated with itraconazole.
authors.affiliation: Internal Medicine 4, Sozialmedizinisches Zentrum Süd - Kaiser-Franz-Josef Hospital, Kundratstraße 3, 1100 Vienna, Austria. PPongratz@gmx.at
authors.forename: Peter
authors.initials: P
authors.lastname: Pongratz
authors.forename: Hermann
authors.initials: H
authors.lastname: Laferl
authors.forename: Günther
authors.initials: G
authors.lastname: Strau
authors.forename: Gerold
authors.initials: G
authors.lastname: Stanek
authors.forename: Christoph
authors.initials: C
authors.lastname: Wenisch
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D002489:Central America; D003371:Cough / Q000209:etiology*; D003937:Diagnosis, Differential; D005335:Fever of Unknown Origin / Q000175:diagnosis* / Q000209:etiology; D006660:Histoplasmosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use*; D008172:Lung Diseases, Fungal / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D013550:Swimming; D013812:Therapeutics
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole