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Abstract

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Article in Japanese

Case Report

A case of pulmonary coccidioidomycosis presented with multiple infliltrative opasities

Toru Kojima  Keiichirou Takase  Junya Nakaya  Kazunari Igarashi  Wataru Yamaguchi  Yasuharu Kaizaki  Takakiyo Nakaya 

Department of Respiratory Medicine, Fukui Prefectural Hospital

ABSTRACT

A 54-year-old man was admitted to our hospital to be operated on for inguinal hernia, but complained of dry cough and cervical lymph nodes swelling after traveling to California in the United States. The chest X-ray films taken on admission showed consolidations in both lungs. The laboratory data revealed an increase in white blood cell counts with eosinophilia, and elevated ESR, IgE and β-D-glucan. The biopsied lung specimen by VATS showed epithelioid granulomas consisting of giant cells and eosinophils. In addition, spherulitic forms filled with endopores were detected in the specimen. A diagnosis of primary pulmonary coccidioidomycosis was made. Eosinophilia and elevated in IgE and β-D-glucan were closely related to the severity of the disease gravity after the treatment with fluconazole.

KEYWORDS

Coccidioidomycosis  Coccidioides immitis  Imported mycoses  Multiple consolidation 

Received 平成19年9月10日

JJRS, 46(5): 390-394, 2008

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