Korean J Med.  2012 Jun;82(6):734-738.

A Case of Disseminated Coccidioidomycosis Involving the Lymph Nodes, the Skin, and the Brain

• Lee JM
• Bae SH
• Lee SN
• Park KH
• Park CK
• Yoon HK
• Song JS

Abstract

Coccidioidomycosis, a fungal infection caused by the fungus known as Coccidioides immitis, can affect many species of mammals and some reptiles. The fungus is endemic in the soil of the southwestern United States, Mexico, and parts of Central and South America. Most infections in humans are relatively mild or asymptomatic, but severe or fatal illness can also occur, especially in the elderly or immunocompromised. We report on a patient with disseminated coccidioidomycosis whose lymph nodes, skin, and especially brain were infected at diagnosis; however, the lung parenchyme was not infected. Because the brain infection could have been a fatal complication in this peculiar case, we recommended life-long fluconazole treatment for the patient. After 2 months of high doses of fluconazole, the patient's clinical signs were greatly improved with respect to fever, headache, skin lesions, and mediastinal widening on the chest X-ray.

Keyword

Disseminated Coccidioidomycosis; Brain; Fluconazole

MeSH Terms

Aged
Brain
Coccidioides
Coccidioidomycosis
Fever
Fluconazole
Fungi
Headache
Humans
Lung
Lymph Nodes
Mammals
Mexico
Reptiles
Skin
Soil
South America
Southwestern United States
Thorax
Fluconazole
Soil