UCLA-Kern Medical, Bakersfield, CA, USA.
Valley Fever Institute, Bakersfield, CA, USA.
J Investig Med High Impact Case Rep. 2023 Jan-Dec;11:23247096231191872. doi: 10.1177/23247096231191872.
We present the case of a 30-year-old man with no prior medical history who presented to the hospital with a myriad of symptoms such as shortness of breath, generalized weakness, lower limb weakness, and urinary retention. He was recently diagnosed with "disseminated coccidioidomycosis" by an outside provider on an outpatient basis and started on fluconazole orally. However, due to a lack of improvement and significant symptoms, he was sent to the hospital to initiate liposomal amphotericin B treatment. After a comprehensive workup, an alternative diagnosis was suspected and eventually confirmed as metastatic germ cell carcinoma. Due to the vast dissemination and his poor functional status despite chemotherapy initiation, the patient elected for palliative care and expired shortly after at hospice. This case demonstrates the similarity of clinical findings between disseminated infections and malignancies.
我们报告了一例 30 岁男性病例，该患者无既往病史，因多种症状（如呼吸困难、全身乏力、下肢无力和尿潴留）到医院就诊。他最近在门诊被一家外部医疗机构诊断为“播散性球孢子菌病”，并开始口服氟康唑治疗。然而，由于症状无明显改善，他被转至医院开始用脂质体两性霉素 B 治疗。经过全面检查，怀疑为另一种诊断，并最终确诊为转移性生殖细胞癌。由于广泛播散和化疗开始后他的功能状态较差，患者选择了姑息治疗，并在临终关怀后不久去世。本例表明，播散性感染和恶性肿瘤的临床发现具有相似性。
