[Coccidioidomycosis as the cause of granulomatous hepatitis].

UNLABELLED: The case of 36-year-old man is reported who fell ill with a febrile infection, shortly after returning from several weeks to Mexico.

EXAMINATION: Chest X-ray revealed a pulmonary infiltration. Also, the levels of liver function tests (gamma-GT, alkaline phosphatase, SGOT, SGPT) were clearly increased. As there were no signs of extended bile ducts in ultrasonics, a liver biopsy was indicated. The histology showed a granulomatous hepatitis.

DIAGNOSIS: The exposure during the Mexico-trip, the pulmonary infiltration, the histology and the significant raised titers in specific serological tests led to the diagnosis of a general infection by the fungus coccidioides immitis. In addition to pathogenetic aspects of coccidioidomycosis the diagnostic approaches and relevant therapeutic strategies are discussed.