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Pulmonary coccidioidal mycetoma.

P K Rohatgi, R G Schmitt

    The American Journal of the Medical Sciences
    |May 1, 1984
    PubMed
    Summary

    Cavitary pulmonary disease from coccidioidomycosis is common, but fungus balls are rare. This case highlights a rare coccidioidal mycetoma as a late complication, requiring surgical intervention.

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    Area of Science:

    • Mycology
    • Pulmonary Medicine
    • Infectious Diseases

    Background:

    • Cavitary pulmonary disease is a frequent manifestation of coccidioidomycosis.
    • Fungal ball (mycetoma) formation within lung cavities caused by Coccidioides immitis is an exceptionally rare occurrence.

    Observation:

    • A unique case of coccidioidal mycetoma developed as a late sequela of primary pulmonary coccidioidomycosis.
    • The patient experienced recurrent hemoptysis, necessitating a lobar resection due to treatment failure with amphotericin B.

    Findings:

    • Histologic examination revealed endosporulating spherules and septate mycelia with arthrospore formation, confirming Coccidioides immitis.
    • The study details the medical and surgical management of this rare fungal ball complication.

    Implications:

    • This case underscores the importance of considering rare fungal ball formation in persistent or complicated coccidioidomycosis.
    • The potential for human-to-human transmission from such lesions warrants further consideration in clinical management and public health.
    • Advanced diagnostic and therapeutic strategies may be required for managing these uncommon sequelae.

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