PDF(Pubmed)
Abstract：
Valley fever is a fungal infection, commonly of the lungs, caused by Coccidioides immitis or Coccidioides posadasii. This disease is endemic to the southwestern United States, Central America, and South America. Infected individuals are typically asymptomatic but may develop community-acquired pneumonia. On rare occasions, coccidioidomycosis can present with severe complications in addition to the pulmonary manifestation. In this study, a 58-year-old immunocompetent male presented to the Emergency Department with a cough, night sweats, and pleuritic chest pain. Despite the administration of broad-spectrum antimicrobials, he developed a large right pleural effusion that did not resolve following thoracentesis. Serology was positive for Coccidioides, and the patient was referred to a thoracic surgeon due to persistent effusion. It is rare for patients with coccidiomycosis to develop a large pleural effusion requiring surgical intervention, especially in immunocompetent individuals. This case highlights the importance of monitoring patients with unresolved acute pneumonia in endemic areas and considering Coccidioides as a possible etiology.
摘要：
山谷热是一种真菌感染，通常是肺部，由球虫或球虫引起。这种疾病是美国西南部特有的，中美洲,和南美洲。受感染的个体通常无症状，但可能发展为社区获得性肺炎。在极少数情况下,球孢子菌病除肺部表现外，还可出现严重的并发症。在这项研究中,一名58岁有免疫能力的男性因咳嗽出现在急诊科，盗汗,胸膜炎性胸痛.尽管广谱抗微生物剂的管理，他出现了大量的右胸腔积液，在胸腔穿刺术后没有消退。球虫血清学呈阳性，由于持续的积液，患者被转诊给胸外科医生。球菌病患者很少出现需要手术干预的大量胸腔积液，尤其是在有免疫能力的个体中。此病例强调了在流行地区监测未解决的急性肺炎患者并将球虫作为可能的病因的重要性。
