Pleural effusion in Michigan caused by Coccidioides immitis after travel to an endemic area.

Primary coccidioidal disease is rarely diagnosed in the midwest in the nonimmunocompromised host. Since coast-to-coast travel is common today, many patients may become exposed to Coccidioides immitis while traveling in endemic areas. We present a case of acute coccidioidal pleural effusion in a Michigan woman who had recently visited northeastern Arizona. Her travel history was the single most important factor in the eventual diagnosis of coccidioidal pleural effusion.