Youngstown State University
Coccidioidomycosis
(coccidioidal Granuloma, Valley Fever, San Joaquin Fever)
➢ Definition
o Caused by
▪ Coccidioides
• Thermally dimorphic fungi
• C. immitis
o Mostly in San Joaquin in California
• C. posadasii
o found
o Easily confused with other fungal infections due to similar histopathology
➢ Case Report 1
Nakamura, Hitomi, Tetsuya Nakamura, Masato Suzuki, Fujihiko Minamoto, Naoki Oyaizu, Toshio Shiba, Makoto Miyaji, and Aikichi Iwamoto. Disseminated coccidioidomycosis with intravertebral and paravertebral abscesses. Journal of Infection and Chemotherapy. 2002. 8: 0178 - 0181
-October of 1997, a 28-year old Japanese man returned to Japan after living in Arizona for 5 years.
-3 months later he developed a fever.
-MRI revealed multiple abscesses surrounding the vertebral bodies from Th7 to Th12.
-A drainage tube was inserted temporarily for diagnostic and therapeutic purposes.
-The drained pus was cultured on brain heart infusion agar with 1% dextrose (BHIDA). Also, cultured on Bact Yeast Nitrogen agar.
-Fungus was identified as Coccidioides immitis.
-After drainage, fever subsided, but new abscesses formed along the inserted drainage tube.
-Sept. 3, 1998: Patient was transferred to the Research Hospital, Institute of Medical Science. When admitted, he had no fever, but complained of mild back pain.
-Tests revealed that C-reactive protein was elevated to 1.97mg/dl (normal range, ................
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