Cargando…

Pandora’s Box: Disseminated Coccidioidomycosis Associated with Self-Medication with an Unregulated Potent Corticosteroid Acquired in Mexico

Coccidioidomycosis (CM), caused by the dimorphic fungi Coccidioides immitis and C. posadasii, typically presents as acute or chronic pulmonary disease. However, disseminated disease occurs in about 1% of patients. Disseminated CM may affect multiple organ systems, including cutaneous, osteoarticular...

Descripción completa

Detalles Bibliográficos
Autores principales: Coba, Alejandro Jose, Sallee, Patricia K., Dixon, Danielle O., Alkhateb, Rahaf, Anstead, Gregory M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8705876/
https://www.ncbi.nlm.nih.gov/pubmed/34941663
http://dx.doi.org/10.3390/tropicalmed6040207
_version_ 1784622055110475776
author Coba, Alejandro Jose
Sallee, Patricia K.
Dixon, Danielle O.
Alkhateb, Rahaf
Anstead, Gregory M.
author_facet Coba, Alejandro Jose
Sallee, Patricia K.
Dixon, Danielle O.
Alkhateb, Rahaf
Anstead, Gregory M.
author_sort Coba, Alejandro Jose
collection PubMed
description Coccidioidomycosis (CM), caused by the dimorphic fungi Coccidioides immitis and C. posadasii, typically presents as acute or chronic pulmonary disease. However, disseminated disease occurs in about 1% of patients. Disseminated CM may affect multiple organ systems, including cutaneous, osteoarticular, and central nervous system sites. Here, we present a case of disseminated CM in a patient from a border city in Texas. The patient had a history of uncontrolled diabetes mellitus and was also taking an over-the-counter medication acquired in Mexico that contained a potent corticosteroid. The patient presented with seizures and was found to have a brain infarct, cavitary lung lesions, synovitis of the knee, multiple skin lesions, and chorioretinitis. The patient had a very high complement fixation titer for Coccidioides; fungal spherules were seen in a skin biopsy specimen, and Coccidioides grew in culture from a sample of synovial fluid and the skin biopsy specimen. This case illustrates the dissemination potential of Coccidioides, the danger of unregulated pharmaceuticals, the importance of thorough history taking, and recognizing risk factors that contribute to disseminated CM.
format Online
Article
Text
id pubmed-8705876
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-87058762021-12-25 Pandora’s Box: Disseminated Coccidioidomycosis Associated with Self-Medication with an Unregulated Potent Corticosteroid Acquired in Mexico Coba, Alejandro Jose Sallee, Patricia K. Dixon, Danielle O. Alkhateb, Rahaf Anstead, Gregory M. Trop Med Infect Dis Case Report Coccidioidomycosis (CM), caused by the dimorphic fungi Coccidioides immitis and C. posadasii, typically presents as acute or chronic pulmonary disease. However, disseminated disease occurs in about 1% of patients. Disseminated CM may affect multiple organ systems, including cutaneous, osteoarticular, and central nervous system sites. Here, we present a case of disseminated CM in a patient from a border city in Texas. The patient had a history of uncontrolled diabetes mellitus and was also taking an over-the-counter medication acquired in Mexico that contained a potent corticosteroid. The patient presented with seizures and was found to have a brain infarct, cavitary lung lesions, synovitis of the knee, multiple skin lesions, and chorioretinitis. The patient had a very high complement fixation titer for Coccidioides; fungal spherules were seen in a skin biopsy specimen, and Coccidioides grew in culture from a sample of synovial fluid and the skin biopsy specimen. This case illustrates the dissemination potential of Coccidioides, the danger of unregulated pharmaceuticals, the importance of thorough history taking, and recognizing risk factors that contribute to disseminated CM. MDPI 2021-12-05 /pmc/articles/PMC8705876/ /pubmed/34941663 http://dx.doi.org/10.3390/tropicalmed6040207 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Coba, Alejandro Jose
Sallee, Patricia K.
Dixon, Danielle O.
Alkhateb, Rahaf
Anstead, Gregory M.
Pandora’s Box: Disseminated Coccidioidomycosis Associated with Self-Medication with an Unregulated Potent Corticosteroid Acquired in Mexico
title Pandora’s Box: Disseminated Coccidioidomycosis Associated with Self-Medication with an Unregulated Potent Corticosteroid Acquired in Mexico
title_full Pandora’s Box: Disseminated Coccidioidomycosis Associated with Self-Medication with an Unregulated Potent Corticosteroid Acquired in Mexico
title_fullStr Pandora’s Box: Disseminated Coccidioidomycosis Associated with Self-Medication with an Unregulated Potent Corticosteroid Acquired in Mexico
title_full_unstemmed Pandora’s Box: Disseminated Coccidioidomycosis Associated with Self-Medication with an Unregulated Potent Corticosteroid Acquired in Mexico
title_short Pandora’s Box: Disseminated Coccidioidomycosis Associated with Self-Medication with an Unregulated Potent Corticosteroid Acquired in Mexico
title_sort pandora’s box: disseminated coccidioidomycosis associated with self-medication with an unregulated potent corticosteroid acquired in mexico
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8705876/
https://www.ncbi.nlm.nih.gov/pubmed/34941663
http://dx.doi.org/10.3390/tropicalmed6040207
work_keys_str_mv AT cobaalejandrojose pandorasboxdisseminatedcoccidioidomycosisassociatedwithselfmedicationwithanunregulatedpotentcorticosteroidacquiredinmexico
AT salleepatriciak pandorasboxdisseminatedcoccidioidomycosisassociatedwithselfmedicationwithanunregulatedpotentcorticosteroidacquiredinmexico
AT dixondanielleo pandorasboxdisseminatedcoccidioidomycosisassociatedwithselfmedicationwithanunregulatedpotentcorticosteroidacquiredinmexico
AT alkhatebrahaf pandorasboxdisseminatedcoccidioidomycosisassociatedwithselfmedicationwithanunregulatedpotentcorticosteroidacquiredinmexico
AT ansteadgregorym pandorasboxdisseminatedcoccidioidomycosisassociatedwithselfmedicationwithanunregulatedpotentcorticosteroidacquiredinmexico