Anesthetic management for lobectomy in a patient with coccidioidomycosis: a case report

Coccidioidomycosis is a fungal disease with a wide variety of manifestations. The systemic infection is a product of airborne spore inhalation released from the soil. This once-endemic disease is steadily increasing in incidence, geographic location, and severity. The rare coccidioidomycosis cases requiring surgical intervention present unique challenges to anesthesia providers. This case report describes a 45-year-old woman with no relevant medical history admitted for lobec-occidi tomy with decortication because of aggressive coccidioidomycosis. Anesthetic considerations included attention to fungal sepsis, acute tubular necrosis related to amphotericin B therapy, and airway challenges. Careful attention to perioperative fungal therapies, invasive monitoring, and electrolyte stabilization remain pivotal concerns offering the best outcomes for patients with coccidioidomycosis.