Tuberc Respir Dis.  2005 Apr;58(4):399-403.

A Case of Disseminated Coccidioidomycosis Involving Lung and Skin in Patient with Diabetes Mellitus and Iatrogenic Cushings Syndrome

• Han SY
• Kim CH
• Son KP
• Kim JK
• Byun HW
• Kim YS
• Jeong IK
• Woo HJ
• Hyun IG
• Jung KS
• Lee ES

Abstract

Coccidioidomycosis is caused by a dimorphous fungus, Coccidioides, which consists of two species, C. immitis and C. posadasii. Although these organisms are genetically distinct and do not exchange DNA, they appear identical phenotypically and the disease or immune response to the organisms is also identical. Coccidioides grows as a mycelium in the soil and is mainly found in Southwestern United States, northwestern Mexico, and Argentina. An infection usually results from inhaling the spores of the fungus in an endemic area. Patients with a localized infection and no risk factors for complications often require only a periodic reassessment to demonstrate the resolution of the self-limited process. However, patients with extensive spread of infection or high risk of complications as a result of immunosuppression or other preexisting factors require a variety of treatment strategies such as antifungal therapy, surgical debridement, or both. Korea is not endemic area of a coccidioidomycosis. We report a case of disseminated coccidioidomycosis involving the lung and skin, which was detected incidentally after sunburn in a 69 year-old Korean male with diabetes mellitus and iatrogenic Cushings syndrome, with a review of the relevant literature.

Keyword

Coccidioidomycosis; Sunburn; Diabetes mellitus; Cushings syndrome

MeSH Terms

Aged
Argentina
Coccidioides
Coccidioidomycosis*
Debridement
Diabetes Mellitus*
DNA
Fungi
Humans
Immunosuppression
Inhalation
Korea
Lung*
Male
Mexico
Mycelium
Risk Factors
Skin*
Soil
Southwestern United States
Spores
Sunburn
DNA
Soil