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Perplexing pericarditis caused by coccidioidomycosis

D E Amundson1

  • 1Department of Internal Medicine (Pulmonary Division), Naval Hospital, San Diego, CA 92134-5000.

Southern Medical Journal
|June 1, 1993
PubMed
Summary
This summary is machine-generated.

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Coccidioidomycosis can mimic idiopathic pericarditis, presenting as an endobronchial mass. Early airway compromise may signal chronic fungal disease, treatable with fluconazole.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Cardiology

Background:

  • Coccidioidomycosis is a fungal infection endemic to specific regions.
  • Idiopathic pericarditis presents as inflammation of the pericardium without a clear cause.
  • Chronic pulmonary coccidioidomycosis can manifest with diverse clinical presentations.

Observation:

  • A patient with chronic progressive pulmonary coccidioidomycosis was initially evaluated for cryptogenic pericarditis.
  • An unsuspected large endobronchial coccidioidoma was discovered during the diagnostic workup.
  • The patient presented with symptoms suggestive of airway obstruction.

Findings:

  • Treatment with fluconazole for 2 years resulted in asymptomatic status and reduced pulmonary infiltrates.
  • Coccidioidal Complement Fixation (CF) titers remained unchanged despite clinical improvement.

Related Experiment Videos

  • Endobronchial coccidioidoma was the underlying cause of the patient's symptoms.

    • Implications:

    • Coccidioidomycosis should be considered in the differential diagnosis of idiopathic pericarditis, particularly in endemic areas and high-risk individuals.
    • Airway obstruction or compromise may be an early indicator of chronic coccidial infections.
    • Prompt diagnosis and treatment of coccidioidomycosis are crucial for managing complex presentations.