Acute Pulmonary Coccidioidomycosis-A Case Report

Abstract

Coccidioidomycosis (valley fever) is caused by the dimorphic fungus ”Coccidioides immitis”. The disease is endemic to the southwestern United States. Coccidioides species live in the soil and produce pulmonary infection via airborne arthroconidia. Most coccidioidal infections are self-limited and resolve with or without antifungal treatment. Severe pulmonary involvement may occur, especially in immunocompromised patients, but rarely. We presented a 51-year-old man with acute pulmonary coccidioidomycosis diagnosed via sputum culture and histopathological examination. He had fever and productive cough with whitish sputum for 7 days initially, and then developed acute respiratory distress syndrome (ARDS) and septic shock. We prescribed amphotericin B 75 mg once daily by intravenous administration. His clinical condition and chest radiography improved, and gradual, successful extubation was performed 9 days later.