Department of Internal Medicine, Division of Infectious Diseases, UCLA at Kern Medical Center, Bakersfield, CA, USA.
Valley Fever Institute, Bakersfield, CA, USA.
J Investig Med High Impact Case Rep. 2022 Jan-Dec;10:23247096221098339. doi: 10.1177/23247096221098339.
Coccidioidomycosis (CM) is a fungal infection endemic to the southwestern United States with a wide range of clinical presentations depending on the infected organ systems. Most infections are asymptomatic. Coccidioidomycosis causes a primary pulmonary infection and when symptoms occur, they most often resemble community-acquired pneumonia. One percent of cases disseminate, typically via hematogenous or lymphatic spread. It is in these cases that more severe symptoms may present and potentially overlap with those characteristics of other systemic illnesses. This is a case of CM disseminated to lymph nodes in a 24-year-old man with concomitant metastatic embryonal carcinoma. It is difficult to identify the primary etiology for many components of this patient's presentation, including diffuse lymphadenopathy and multiple pulmonary nodules. Furthermore, the relationship between these 2 concurrent disease processes is not entirely clear. Factors that may contribute include the well-known phenomenon of locus minoris resistentiae (LMR) or potentially a shared immune failure between infectious organisms and malignant cells.
球孢子菌病（CM）是一种真菌性传染病，流行于美国西南部，其临床表现因感染的器官系统而异。大多数感染无症状。球孢子菌病引起原发性肺部感染，当出现症状时，通常类似于社区获得性肺炎。1%的病例会扩散，通常通过血行或淋巴传播。正是在这些情况下，更严重的症状可能会出现，并可能与其他系统性疾病的特征重叠。这是一例播散性球孢子菌病病例，发生于一名 24 岁男性，伴有转移性胚胎癌。很难确定该患者表现的许多成分的主要病因，包括弥漫性淋巴结病和多个肺结节。此外，这两种并发疾病之间的关系尚不完全清楚。可能导致这种情况的因素包括众所周知的小抵抗部位现象（LMR）或感染性生物和恶性细胞之间潜在的共同免疫缺陷。
