Pulmonary sequestration is a rare congenital or acquired pulmonary anomaly. Pulmonary sequestration may be classified as intralobar, located within normal lung, or extralobar, in which it is separated by pleura. The coexistence of both forms is extremely rare. Infection, mainly bacterial, is a major complication of sequestration. We report the case of a young man in whom a sequestration with both intralobar and extralobar components was complicated by Nocardia asteroides infection.
Coccidioides immitis causes a benign upper respiratory tract infection in endemic areas. Acute respiratory distress syndrome is a rare complication that is associated with high mortality. Corticosteroids have been avoided as adjunctive therapy to antifungals in the treatment of acute respiratory distress syndrome secondary to coccidioidomycosis because of the fear of enhancing fungal virulence, but they have been proven safe and effective in other infectious entities. We are presenting a case of severe acute respiratory distress syndrome owing to a fulminant coccidioidomycosis infection that responded to a short course of systemic corticosteroids in addition to the standard antifungal treatment.
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