Valley Fever in the UK? - The importance of a travel history

Abstract

Summary Coccidioidomycosis, also known as Valley Fever, is a fungal infection caused by the inhalation of spores, and is endemic in the Southwestern United States; regions of Mexico, Central America and South America. 1 It therefore came as a surprise to isolate this infection from a patient in a seaside town in North Yorkshire, UK. Coccidioidomycosis is caused by either Coccidioides immitis or Coccidioides posadasii , and once inhaled they are highly infectious, and can cause a wide variation in clinical manifestation and imaging findings.1 Most infections primarily involve the lungs, and are self-limiting and resolve over a period of weeks to months. 2 Occasionally the infection can spread to cause a very serious disseminated disease. The radiographic findings can be nonspecific and variable, often raising concern for many differential diagnoses such as malignancy, other infections or granulomatous conditions. 1,3 Relevance This was an interesting case of a female patient in the UK presenting with nonspecific respiratory symptoms, and eventually being diagnosed with a fungal infection typically found in the Southwestern United States. Take Home Messages It highlights the importance of enquiring about a travel history, and conducting appropriate imaging, even when the initial picture points towards a less exotic, more sinister diagnosis.