Fungal disease of the Western hemisphere: a patient with coccidioidomycosis.

We report the case of a 58 year old male patient with nonproductive coughing, fever, vomiting and loss of appetite, beginning at the moment that he returned back home from a 2 week holiday in California. His symptoms were accompanied by increased inflammatory markers in his blood (leucocytosis, high CRP) and pulmonary sequelae, becoming more prominent shortly after admission. Eventually, the final diagnosis of coccidioidomycosis was made by histopathology and confirmed by serology. Coccidioidomycosis is a rare infectious disease. However, the incidence in the endemic areas of this fungal infection is increasing and the population travelling towards its specific endemic regions in the United States and Southern America is considerably growing. Clinicians facing patients with pulmonary infection with the appropriate travel history and persistent pulmonary or systemic infection (with or without eosinophilia) should be alert to the possibility of coccidioidomycosis. Therefore, we present an up to date overview of the epidemiology, microbiology, clinical features, diagnosis and treatment of patients with coccidioidomycosis.