Pulmonary coccidioidomycosis: import illness and the importance of travel history

• Published in: Netherlands journal of medicine Vol. 67; no. 10; pp. 353 - 355
• Main Authors: INDHIRAJANTI, S, MAARTENSE, E, POSTHUMA, E. F. M, PANNEKOEK, B. J. M, VREEDE, R. W
• Format: Journal Article
• Language: English
• Published: Alphen aan den Rijn Van zuiden 01-11-2009
• Subjects: Adult; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antifungal agents; Antifungal Agents - therapeutic use; Biological and medical sciences; Bronchoalveolar Lavage Fluid; California; Coccidioidomycosis; Coccidioidomycosis - diagnosis; Coccidioidomycosis - drug therapy; Coccidioidomycosis - etiology; Desert Climate; General aspects; Human mycoses; Humans; Infectious diseases; Itraconazole - therapeutic use; Lung Diseases, Fungal - diagnosis; Lung Diseases, Fungal - drug therapy; Lung Diseases, Fungal - etiology; Male; Medical sciences; Mycoses; Netherlands; Pharmacology. Drug treatments; Tomography, X-Ray Computed; Travel; Treatment Failure; Tropical mycoses; Netherlands; California; Lung disease; Pneumonia; Import; Mycosis; Respiratory disease; Azole derivatives; Lung; History; Respiratory system; Case history; Infection; Medicine; Travel; Antifungal agent; Imported disease; Coccidioidomycosis; Triazole derivatives; import illness; Itraconazole
• ISSN: 0300-2977; 1872-9061

A 35-year-old man presented at the outpatient department of pulmonary diseases with fever, rhinitis and coughing. He had recently been on holiday in California. Except for a body temperature of 39.7 degrees C there were no other abnormal findings at the physical examination. Chest X-ray showed a consolidation in the left upper lobe. Under antibiotic treatment his clinical condition deteriorated. Coccidioidomycosis was the suspected diagnosis and confirmed by the results of CT scanning and culture of bronchoalveolar lavage fluid. Treatment with itraconazole resulted in lasting improvement. The case stipulates the importance of travel history.