• Respirology · Mar 2000

    Case Reports

    Multi-organ failure caused by reactivated coccidioidomycosis without dissemination in a patient with renal transplantation.

    • J M Cha, S Jung, H S Bahng, C M Lim, D J Han, J H Woo, and Y Koh.
    • Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
    • Respirology. 2000 Mar 1;5(1):87-90.

    ObjectiveThe acute respiratory failure caused by pulmonary coccidioidomycosis without dissemination is an extremely unusual event.Case ReportWe report a 47-year-old renal transplanted man with a reactivated pulmonary coccidioidomycosis, whose clinical course presented as fulminant respiratory failure, disseminated intravascular coagulation and profound hypotension mimicking bacterial pneumonia and septic shock. Lung biopsy showed conglomerated necrotizing granulomas containing many spherules filled with endospores of Coccidioides immitis.ConclusionCoccidioidomycosis should be included in the differential diagnosis of acute sepsis, particularly in an immunocompromised host who has travelled in an endemic area.

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