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2004, Number 2

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Rev Med Hosp Gen Mex 2004; 67 (2)

Disseminated coccidioidomycosis with lungs, lymph nodes and meningeal involvement. A case with important things at autopsy

López-Márquez A, Hernández-Avendaño V, Durán-Padilla MA, Navidad CF, Chávez-Macías L, Olvera-Rabiela J

Language: Spanish
References: 11
Page: 88-93
PDF size: 160.79 Kb.


ABSTRACT

Coccidioidomycosis is a deep mycosis; it is caused by a two-phase fungus that is called Coccidioides immitis. It has a saprophytic stage (mycelium); and a hypha portion (artroconidium) that is inhaled by the host and, therefore, it can transgress the mucociliary wall. In the lung elicits a neutrophilic and hystiocitic response; and the microorganism changes to parasitic stage, the spherula. The clinical manifestations in coccidioidomycosis can be due to the lung and skin involvement or the progressive and disseminated illness. A case of a teenager is presented in which the central nervous system illness had a course of nine months, with rather non-specific manifestations. The etiology of the illness was not determinated during life. The autopsy revealed involvement of the basal subarachnoid space, lungs and lymph nodes by Coccidioides immitis. This case is reported because of the importance to consider this entity in the differential diagnosis in patients with granulomatous leptomeningitis without an immunodeficient state.


REFERENCES

  1. Bonifaz A. Coccidioidomicosis. En: Micología médica básica. México: Méndez Cervantes Editores, 1991; 215-232.

  2. Mischel PS, Vinters HV. Coccidioidomycosis of the central nervous system: Neuropathological and vasculopathic. Manifestations and clinical correlates. Clin Infect Dis 1995; 20: 400-405.

  3. Gurrola MT, González ML, Olvera RJ. Coccidioidomicosis con afección del sistema nervioso central frecuencia y características en material de autopsias. Patología 1987; 25: 31-40.

  4. Batí SU, Aguet J, Stenvens DA. Central nervous system abscesses due to coccidioides species. Clin Infect Dis 1996; 22: 240-250.

  5. Kleinchmidt-De Master BK, Mazowiecki M, Bonds LA, Cohn DL, Wilson ML. Coccidioidomycosis meningitis with massive dural and cerebral venous trombosis and tissue arthroconicia. Arch Pathol Lab Med 2000; 124: 310-314.

  6. Wages DS, Helfend L, Finkie H. Coccidioides immitis presenting as a hyphal form in a ventriculoperitoneal shunt. Arch Pathol Lab Med 1995; 119: 91-93.

  7. Galgiani JN, Peng T, Lewis ML, Cloud GA, Pappaganis D. Cerebrospinal fluid antibodies detected by ELISA against a 33-Kda antigen from spherules of coccidioides immitis in patients with coccidioidal meningitis. J Infect Dis 1996; 173: 499-502.

  8. Martínez MM, Godoy OL, León SJ, López CG. Coccidioidomicosis meníngea en niños. Estudio de cinco casos. Bol Med Hosp Infant Mex 1983; 40: 517-522.

  9. Kauffman CA, Wiseman SW. Anaphylaxis upon switching lipid-containing amphotericin B formulations. Clin Infect Dis 1998; 26: 1237-1238.

  10. Galgiani JN, Ampel NM, Catanzaro A, Johnson RH, Stevens DA, Williams PL. Practice Guidelines for the Treatment of Coccidioidomycosis. Clin Infect Dis 2000; 30: 658-661.

  11. Godoy OL, Martínez MM, León SJ, Bonillas FE. Coccidioidomicosis en el niño. Bol Med Hosp Infant Mex 1983; 40: 504-510.




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