Coccidioidomycosis and paracoccidioidomycosis

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Coccidioidomycosis and paracoccidioidomycosis

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A 45-year-old man comes to his physician for evaluation of a chronic cough over the past several months. A chest x-ray is performed and shows bilateral infiltrates. A sputum microscopy is performed and shown below. To which of the following locations did this patient most likely travel?
 
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External References

First Aid

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Coccidioides spp.

silver stain p. 123

treatment p. 195

Summary

Coccidioidomycosis, also known as Valley fever, is a fungal infection caused by Coccidioides immitis. It typically presents with pneumonia symptoms like fever, chest pain, and cough, but can also present with joint pain, and skin manifestations such as erythema nodosum and erythema multiforme.

Paracoccidioidomycosis is another fungal infection caused by Paracoccidioides brasiliensis and Paracoccidioides lutzii. It typically presents with skin and mouth ulcers, lymphadenopathy, hepatosplenomegaly, adrenal insufficiency, and aplastic anemia in case the bone marrow is affected.