Mini-Review of Published Reports on Coccidioidomycosis in China

Coccidioidomycosis is a deep mycotic infection endemic to Americas. Although it has also been reported to occur in non-endemic areas, it has rarely been reported in China. We reviewed the literature on case reports of coccidioidomycosis in China from 1958 to 2015. A total of 30 cases were reported from 11 provinces in China, and 23 (76.7%) cases were men, and 23 (76.7%) were in 30-60 years old. Twenty-seven (90.0%) cases were reported from southern China. Twenty-four (80.0%) cases had no history of exposure in endemic areas. Three cases were immunosuppressed, four cases had chronic disease, and 23 cases (76.7 %) were otherwise healthy. Twenty cases (66.6%) had related lung infection, six had skin infection, three cases were in lymph node, and one in the cornea, one in the bone and joint, and three had systemic disseminated infection. All of the 30 cases were diagnosis upon finding spherules in histological examination. Interestingly, 12 (40.0%) patients underwent surgery and removed the focus of infection because they were misdiagnosed or suspected of tumor or cancer previously. Fifteen cases (50.0%) were treated with amphotericin B, fluconazole, clotrimazole or ketoconazole. Diagnosis of coccidioidomycosis is complex, and misdiagnosis can occur easily in non-epidemic areas such as China.