[Case of pulmonary coccidioidomycosis presented with multiple infiltrative opacities].

A 54-year-old man was admitted to our hospital to be operated on for inguinal hernia, but complained of dry cough and cervical lymph nodes swelling after traveling to California in the United States. The chest X-ray films taken on admission showed consolidations in both lungs. The laboratory data revealed an increase in white blood cell counts with eosinophilia, and elevated ESR, IgE and beta-D-glucan. The biopsied lung specimen by VATS showed epithelioid granulomas consisting of giant cells and eosinophils. In addition, spherulitic forms filled with endopores were detected in the specimen. A diagnosis of primary pulmonary coccidioidomycosis was made. Eosinophilia and elevated in IgE and beta-D-glucan were closely related to the severity of the disease gravity after the treatment with fluconazole.