Coccidioidomicosis extrapulmonar: Presentación de un caso y revisión de la literatura

Abstract

Extrapulmonary coccidioidomycosis. Case report and reviewCoccidioidomycosis is a deep mycotic infection endemic in the Southwestern part of the United States and Mexico and certain areas of Central and South America. The causative agents are fungi of the genus Coccidioides. Primary infection usually involves the lungs, and dissemination occurs in less than 1% of cases. While the extrapulmonary disease usually involves the skin, central nervous system, bones or joints, it can involve any tissue or organ. We present a case of extrapulmonary coccidioidomycosis in a 20-year-old male, in whom the diagnosis was made by a lymph node biopsy. His past history was not significant and the biopsy was performed because the physical findings were suggestive of lymphoma.

Coccidioidomycosis: skin manifestations and hypersensitivity syndromes

“…Only 0.2% of immunocompetent patients present with disseminated disease (2,17), defined as compromise outside the thoracic cavity, but in immunosuppressed patients, it may be up to 50% (18). It usually occurs by hematogenous or lymphangitic dissemination, mainly to the skin, the central nervous system, manifesting as headache and hydrocephalus, and to the bones, with a penchant for axial structures such as the vertebrae, skull, sternum, and ribs (19)(20)(21)(22)(23)(24).…”

Coccidioidomycosis and Histoplasmosis in Equines: An Overview to Support the Accurate Diagnosis

“…In humans, primary pulmonary infection is asymptomatic in 60% of cases. Infected individuals have no symptoms or exhibit common symptoms of upper respiratory tract infection [71], ranging from flu-like to severe nonspecific respiratory infection in more severe cases. Primary pulmonary coccidioidomycosis usually resolves spontaneously within 30-60 days, even without antifungal treatment [72].…”

Los métodos de laboratorio en el diagnóstico de la coccidioidomicosis

“…La tinción más útil para resaltar la presencia tisular del hongo es la metenamina-plata de Gomori-Grocott (GG), con la que el hongo se tiñe de negro sobre fondo verde 5 . El diagnóstico se establece por la observación de esferas de 10-100 µm de diámetro, que se dividen por endopartición formándose así las endosporas nucleadas de 2-5 µm; la pared celular de la esfera es gruesa, de 2 µm, y birefrigente 1,2,6 . Coccidioides spp.…”

“…C) Esfera madura con abundantes endosporas que salen al exterior, H y E 400x. general, la diferenciación de las dos especies, ambas generan cuadros clínico-patológicos semejantes para el hospedero 1,2,6 . En los laboratorios de referencia, puede realizarse la reacción de polimerasa en cadena (RPC) con partidores (primers) específicos, más la determinación detallada de la secuencia molecular, proceso de interés principal para los epidemiólogos y taxonomistas.…”