[A case of pulmonary coccidioidomycosis]

A 55-year-old Japanese woman was admitted to our hospital, complaining of flu-like symptoms and left-sided chest pain. Her chest X-ray films revealed a solitary coin lesion in the left middle lung field. She had traveled to California and Arizona 3 months before being taken ill. Because of negative result in sputum cytology and trans-bronchial lung biopsy examination, open lung biopsy and wedge resection was performed. Histological examination revealed endosporulating spherules in a caseous lesion of the epithelioid granulomas, and fungal cultures demonstrated barrel-shaped arthropores. Pulmonary coccidioidomycosis was diagnosed. Coccidioidomycosis is a rare fungal disease found in certain endemic areas in the southwestern region of the United States. She had been infected during her travels in America, and this is the second case in Japan who had taken surgical intervention for pulmonary coccidioidomycosis.