Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Pulmonary Coccidioidomycosis in Immunocompetent Patient

정상 면역력 환자에서 발생한 콕시디오이데스 진균증 1예

  • Kim, Se Won (Department of Internal Medicine, University of Dongguk College of Medicine, Dongguk University Ilsan Hospital) ;
  • Oh, Jin Young (Department of Internal Medicine, University of Dongguk College of Medicine, Dongguk University Ilsan Hospital) ;
  • Kim, Eo-Jin (Department of Pathology, University of Dongguk College of Medicine, Dongguk University Ilsan Hospital) ;
  • Park, Gun Min (Department of Internal Medicine, University of Dongguk College of Medicine, Dongguk University Ilsan Hospital)
  • 김세원 (동국대학교 의과대학 동국대학교 일산병원 내과학교실) ;
  • 오진영 (동국대학교 의과대학 동국대학교 일산병원 내과학교실) ;
  • 김어진 (동국대학교 의과대학 동국대학교 일산병원 병리학교실) ;
  • 박근민 (동국대학교 의과대학 동국대학교 일산병원 내과학교실)
  • Received : 2008.12.24
  • Accepted : 2009.02.26
  • Published : 2009.03.30
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Abstract

Coccidioidomycosis is a fungal infection caused by the soil fungus, Coccidioides immitis, which is endemic to the south-western United States. However, the incidence of coccidioidomycosis has recently increased due to the increase in overseas travel to endemic areas. We report a case of pulmonary coccidioidomycosis diagnosed in an immunocompetent person. A 28-year-old female, who had lived in Phoenix, Arizona, USA for 2 years, was admitted for an evaluation of persistent cough with fever lasting for 2 weeks. The chest X-ray and Chest CT revealed multifocal patchy consolidation and ground-glass opacity in both lungs as well as multiple enlarged right hilar and paratracheal lymph nodes. A percutaneous needLe biopsy of the main mass-like consolidation confirmed mature spherules of Coccidioides immitis in lung tissue. Pulmonary coccidioidomycosis should be considered in patients presenting with persistent cough with fever and a history of travel to or immigration from an endemic area.

콕시디오이데스 진균증은 미국 남서부 지역의 풍토병으로 알려져 있고 국내 발병 사례가 적으므로 진단에 혼선과 지연을 초래할 수 있다. 따라서 풍토지역 거주력이나 여행력을 문진하는 것이 매우 중요하고 호산구 증다증을 동반할 경우 콕시디오이데스 진균증을 감별질환의 한 가지로 생각해야 할 것이다. 또한 의심이 되는 경우 적극적인 조직검사 및 엄격한 보호아래 시행되는 배양검사를 통한 진단과 치료가 필요하겠다. 저자들은 C.immitis 풍토지역인 미국 애리조나 주에서 거주 후 입국한 정상 면역력환자에서 다발성 폐경화 및 폐문부 림프절 비대 소견을 보여 조직 검사와 기관지세척액 및 폐조직배양검사를 통하여 폐 콕시디오이데스 진균증으로 진단한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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