A case of pulmonary coccidioidomycosis mimicking lung cancer / 대한내과학회지

ABSTRACT

Coccidioidomycosis is a fungal infection caused by the soil fungus Coccidioides immitis, which is endemic to the south-western United States. Increasingly, cases are being recognized outside the endemic area, due to travelers who have visited the endemic area. Here, we report a case of pulmonary coccidioidomycosis in a Korean man who has traveled in Arizona, U.S.A. Cardinal clinical symptoms were fever, central lung mass with mediastinal lymphadenopathy on the chest X-ray which mimicked lung cancer, and a 14% eosinophilia in the peripheral blood. Coccidioidomycosis was diagnosed by serology and mediastinoscopic biopsy by identifying typical spherules. The symptoms disappeared spontaneously without specific treatment. Coccidioidomycosis must be considered in the differential diagnosis of pulmonary infiltrates with peripheral eosinophilia, especially if patient has lived in or visited endemic area.