Coccidioides immitis (Coccidiomycosis) Valley Fever, Dersert Dumps

Question 1

How does the patient present?

Answer 1

recent travel history,

major weight loss within short time frame,

hypoxia,

night sweats,

joint pain,

dry cough,

severe fatigue,

erythematous multiforme (lumpy lesions on back /type 4 HS)

and maybe erythema nodosum (calcification seen on healing lesions),

lung infiltrates bilaterally (lobar or segmental consolidation) ,

INCREASED eosinophils

Question 2

Where is fungus commonly acquired ?

Answer 2

southwestern US, Mexico

Question 3

Lab CXR shows

Answer 3

bilateral lung infiltrates

Question 4

Lab Culture

Answer 4

NOT ROUTINELY DONE why? organism is highly infectious and can cause biohazard

however, Sabouraud agar or Sabouraud dextrose agar (SDA) demonstrates mold colonies at 25%

Question 5

Lab Stainings

Answer 5

Tissue specimen with H&E

Question 6

Anthrospores presentation in environment

Answer 6

rectangular shaped in chain

Question 7

Presentation in vitro

Answer 7

Spherules with endopores

Question 8

Treatment

Answer 8

Ketoconazole, intraconazole, fluconazole, Amphotericin B.

Question 9

ethnicities at higher risk?

Answer 9

Filipinos, African Americans

Question 10

path

Answer 10

inhalation of arthrospores cause alveoli to transform to thick walled non budding spherules in the bronchioles; eosiniphilic response; chronic granulomatous inflammatory response in the tissues