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Coughing and fever after surfing in Central America
Peter Pongratz1, Hermann Laferl, Günther Strau
1Internal Medicine 4, Sozialmedizinisches Zentrum Süd - Kaiser-Franz-Josef Hospital, Kundratstraße 3, 1100 Vienna, Austria. PPongratz@gmx.at
Abstract:
We report the case of a 19-year-old surfer, returning from Central America, who presented with chronic cough. The X-ray and full blood count, which had been performed in Costa Rica, were without pathology; laboratory parameters showed slightly increased C-reactive protein (59 mg/l). Malaria was excluded by thick smear. Immune serological tests for typhus, paratyphus, brucellosis, rickettsioses, leptospirosis and dengue fever were negative. An ambulant antimicrobial treatment was without any clinical effect. A computer tomography of the thorax showed a solid lesion (30 × 20 mm, middle lobe of the right lung). The patient rejected a bronchoscopic examination. He decided to be treated after his return to Austria. Here, we could substantiate a pulmonal histoplasmosis by a positive immune diffusion test. The patient was successfully treated with itraconazole.
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