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Sexual Development and Ascospore Discharge in Fusarium graminearum
Published on: March 29, 2012
Spherules, hyphae, and air-crescent sign
Adriano R Tonelli1, Walid T Khalife, Ming Cao
1Department of Internal Medicine, Michigan State University, East Lansing, Michigan 48824, USA. adriano.tonelli@medicine.ufl.edu
The American Journal of the Medical Sciences
|June 17, 2008
Summary
Coccidioidomycosis, a fungal infection, can rarely cause pyopneumothorax. Early diagnosis and treatment are crucial for patients with risk factors like smoking, especially in endemic areas.
Area of Science:
- Mycology
- Infectious Diseases
- Pulmonology
Background:
- Coccidioidomycosis is endemic in the southwestern US, causing 100,000 infections annually, often asymptomatic or presenting as pneumonia.
- Rarely, Coccidioidomycosis can manifest as a pyopneumothorax with mononuclear cell predominance.
Observation:
- A 72-year-old male smoker with Coccidioidomycosis presented with weakness, night sweats, dyspnea, and chest pain.
- Imaging revealed a cavitary infiltrate with an air-crescent sign and hydropneumothorax.
- Pleural fluid analysis showed an eosinophilic exudate; tissue biopsy revealed fungal elements.
Findings:
- Coccidioides immitis was cultured from the surgical specimen.
- The patient was diagnosed with chronic fibrocavitary pneumonia with pyopneumothorax secondary to C. immitis.
- Complement fixation was positive at 1:2, while latex agglutination was negative.
Implications:
- Coccidioidomycosis should be considered in patients with cavitation, air-crescent sign, eosinophilic pleural effusion, and fungal elements on tissue biopsy.
- Chronic fibrocavitary pneumonia due to Coccidioidomycosis is a consideration in endemic areas, particularly with risk factors like smoking or pulmonary fibrosis.
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