[Coccidioidomycosis--differential diagnosis of lung infiltrates with peripheral eosinophilia]

A 20-year-old man developed pulmonary coccidioidomycosis after travelling in Mexico and California. Cardinal clinical symptoms were fever, pulmonary infiltrate with ipsilateral hilar adenopathy on the chest X-ray, and a 14% eosinophilia in the peripheral blood. In addition he experienced erythema nodosum, arthralgias and night sweats. After a five-week febrile course the symptoms disappeared spontaneously without specific treatment. Coccidioidomycosis was diagnosed by serology, and Coccidioides immitis grew in the sputum culture. With ever more travellers to other parts of the globe coccidioidomycosis must be considered in the differential diagnosis of pulmonary infiltrates with peripheral eosinophilia.