Sri Balaji Vidyapeeth, Pathology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India.
Sri Balaji Vidyapeeth, Pathology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
BMJ Case Rep. 2023 Jul 18;16(7):e253740. doi: 10.1136/bcr-2022-253740.
Coccidioidomycosis is known to occur around the western hemisphere. In tropical countries, the clinical presentation is atypical presenting with a superficial abscess preceded by respiratory tract involvement often mimicking tuberculosis. Eliciting a history of exposure and high suspicion is imperative for early diagnosis.In the present case report, a man in his early 30s presented with complaints of swelling over the neck for the past 2 months with a recent travel history. With a provisional clinical diagnosis of tuberculosis, a biopsy of the swelling revealed features of granulomas with non-caseating necrosis with Coccidioidomycosis organisms demonstrated by fungal stains. Fungal culture and serology reiterated Coccidioides and he recovered after a course of fluconazole.The case report concludes with a statement that Coccidioidomycosis is known to manifest with lymphadenitis mimicking tuberculosis and must be taken into account as one of the differentials. The current report is presented for its rarity in India with atypical presentation.
球孢子菌病已知发生在西半球。在热带国家，临床表现不典型，表现为呼吸道受累前先出现浅表脓肿，常类似于肺结核。询问接触史和高度怀疑对于早期诊断至关重要。在本病例报告中，一名 30 多岁的男子因颈部肿胀就诊，病史为 2 个月，近期有旅行史。根据临床初步诊断为肺结核，对肿胀进行活检显示出肉芽肿特征，伴有非干酪性坏死，真菌染色显示有球孢子菌。真菌培养和血清学检查再次证实为粗球孢子菌，他在接受氟康唑治疗后康复。病例报告的结论是，球孢子菌病可表现为类似于结核病的淋巴结炎，必须作为鉴别诊断之一加以考虑。本报告的特点是在印度罕见，表现不典型。
