title: First imported coccidioidomycosis in Turkey: A potential health risk for laboratory workers outside endemic areas.
abstract: Coccidioidomycosis caused by Coccidioides immitis or Coccidioides posadasii is endemic in arid climate zones in America, travel-related cases have been reported. We report the first documented case of coccidioidomycosis in Turkey, overviewing reported cases in Europe and underlying difficulties of differential diagnosis outside endemic regions. The patient was an otherwise healthy 41-year-old man who travelled endemic areas. Laboratory diagnosis was based on direct microscopy of two subsequent subcutaneous biopsy specimens and culture and confirmed molecularly. Laboratory personnel should become aware that BioSafety Level-3 organisms may become more frequent and widespread.
authors.affiliation: Cerrahpasa Medical Faculty, Department of Medical Microbiology, Deep Mycosis Laboratory, Istanbul University, Istanbul 34098, Turkey.
authors.forename: A Serda
authors.initials: AS
authors.lastname: Kantarcioglu
authors.affiliation: Unitat de Microbiologia, Facultat de Medicina i Ciencies de la Salut, IISPV, Universitat Rovira i Virgili, 43201 Reus, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Sandoval-Denis
authors.affiliation: Cerrahpasa Medical Faculty, Department of Medical Microbiology, Deep Mycosis Laboratory, Istanbul University, Istanbul 34098, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Aygun
authors.affiliation: Cerrahpasa Medical Faculty, Department of Medical Microbiology, Deep Mycosis Laboratory, Istanbul University, Istanbul 34098, Turkey.
authors.forename: Nuri
authors.initials: N
authors.lastname: Kiraz
authors.affiliation: Cerrahpasa Medical Faculty, Department of Radiology, Istanbul University, Istanbul 34098, Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Akman
authors.affiliation: Cerrahpasa Medical Faculty, Department of Neurology, Istanbul University, Istanbul 34098, Turkey.
authors.forename: Hulya
authors.initials: H
authors.lastname: Apaydin
authors.affiliation: Cerrahpasa Medical Faculty, Department of Otorhinolaryngology, Istanbul University, Istanbul 34098, Turkey.
authors.forename: Emin
authors.initials: E
authors.lastname: Karaman
authors.affiliation: Unitat de Microbiologia, Facultat de Medicina i Ciencies de la Salut, IISPV, Universitat Rovira i Virgili, 43201 Reus, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Guarro
authors.affiliation: CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands.
authors.forename: G Sybren
authors.initials: GS
authors.lastname: de Hoog
authors.affiliation: Department of Dermatology, Samatya Training and Research Hospital, Istanbul 34098, Turkey.
authors.forename: M S
authors.initials: MS
authors.lastname: Gurel
keywords: Coccidioides; Coccidioidomycosis; Laboratory safety; Non-endemic countries