ABSTRACT

Coccidioidomycosis is an underdiagnosed infectious disease worldwide, caused by fungi from the Coccidioides spp. family. These fungi are typically found in alkaline, sandy soils of warm and arid regions of the western hemisphere, such as northern Mexico. However, due to migratory displacement, cases of coccidioidomycosis have been documented in non-endemic areas. The primary site of involvement is the lungs; pleural effusion is rare. Disseminated coccidioidomycosis affects 1% of infected patients and is associated with more severe outcomes. We present the case of a 28-year-old male from Chiapas, who has a history of residing in Baja California, without immunocompromising conditions, referred to our unit with atypical disseminated coccidioidomycosis characterized by pulmonary consolidations, lymphadenopathy, subcutaneous abscesses, and pleural effusion.

KEYWORDS

disseminated coccidioidomycosis, coccidioidomycosis in immunocompetent, coccidioidomycosis in non-prevalence region.

REFERENCES

1. Brown J, Benedict K, Park BJ, Thompson GR 3rd. Coccidioidomycosis: epidemiology. Clin Epidemiol. 2013;5:185-197. doi: 10.2147/clep.s34434.

2. Gastélum-Cano JM, Dautt-Castro M, García-Galaz A, Felix-Murray K, Rascón-Careaga A, Cano-Rangel MA, et al. The clinical laboratory evolution in coccidioidomycosis detection: future perspectives. J Mycol Med. 2021;31(3):101159. doi: 10.1016/j.mycmed.2021.101159.

3. Williams SL, Chiller T. Update on the epidemiology, diagnosis, and treatment of coccidioidomycosis. J Fungi (Basel). 2022;8(7):666. doi: 10.3390/jof8070666.

4. Facts and stats about Valley fever. CDC. Valley fever (Coccidioidomycosis). 2024. Available from: https://www.cdc.gov/valley-fever/php/statistics/index.html

5. Laniado-Laborín R, Arathoon EG, Canteros C, Muñiz-Salazar R, Rendon A. Coccidioidomycosis in Latin America. Med Mycol. 2019;57(Supplement_1): S46-S55. doi: 10.1093/mmy/myy037.

6. Johnson RH, Sharma R, Kuran R, Fong I, Heidari A. Coccidioidomycosis: a review. J Investig Med. 2021;69(2):316-323. doi: 10.1136/jim-2020-001655. Erratum in: J Investig Med. 2021;69(8):1486. doi: 10.1136/jim-2020-001655corr1.

7. Odio CD, Marciano BE, Galgiani JN, Holland SM. Risk factors for disseminated coccidioidomycosis, United States. Emerg Infect Dis. 2017;23(2):308-311. doi: 10.3201/eid2302.160505.

8. Diaz JH. Travel-related risk factors for coccidioidomycosis. J Travel Med. 2018;25(1). doi: 10.1093/jtm/tay027.

9. Light RW, Girard WM, Jenkinson SG, George RB. Parapneumonic effusions. Am J Med. 1980;69(4):507-512. doi: 10.1016/0002-9343(80)90460-x.

10. Thompson GR 3rd, Sharma S, Bays DJ, Pruitt R, Engelthaler DM, Bowers J, et al. Coccidioidomycosis: adenosine deaminase levels, serologic parameters, culture results, and polymerase chain reaction testing in pleural fluid. Chest. 2013;143(3):776-781. doi: 10.1378/chest.12-1312.