The first two cases of coccidioidomycosis in Finland

Endemic areas of coccidioidomycosis are described. The mycology of Coccidioides immitis is reviewed, with special reference to the risk of laboratory infection. A classification of coccidioidomycosis is listed and two cases from Finland are presented. The first patient had typical X-ray and clinical findings, including a positive coccidioidin test. The second case, occurring soon after a visit to Arizona, was confirmed by positive fungal cultures from the sputum and from a resected specimen. Because the latter patient became pregnant and the risk of dissemination was considered great, legal abortion was performed. The resection of the pulmonary cavitation with infiltration around it took place under coverage of pre- and postoperative amphotericin B medication. Complete recovery was obtained. The indications for thoracic surgery are briefly listed. Diagnostic and mycologic aspects of this rare and exotic disease are discussed. Among other things, the importance of a good medical history in finding the contact with infective environment or material is stressed.