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Tuberc Respir Dis > Volume 58(4); 2005 > Article
Tuberculosis and Respiratory Diseases 2005;58(4):399-403.
DOI:    Published online April 1, 2005.
A Case of Disseminated Coccidioidomycosis Involving Lung and Skin in Patient with Diabetes Mellitus and Iatrogenic Cushings Syndrome.
Seung Yong Han, , Cheol Hong Kim, , Kwang Pyo Son, , Jin Kyung Kim, , Hyeon Woo Byun, , Young Soon Kim, , In Kyung Jeong, , Heung Jeong Woo, , In Gyu Hyun, , Ki Suck Jung, , Eil Seong Lee,
1Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.
2Department of Radiology, Hallym University College of Medicine, Seoul, Korea.
Coccidioidomycosis is caused by a dimorphous fungus, Coccidioides, which consists of two species, C. immitis and C. posadasii. Although these organisms are genetically distinct and do not exchange DNA, they appear identical phenotypically and the disease or immune response to the organisms is also identical. Coccidioides grows as a mycelium in the soil and is mainly found in Southwestern United States, northwestern Mexico, and Argentina. An infection usually results from inhaling the spores of the fungus in an endemic area. Patients with a localized infection and no risk factors for complications often require only a periodic reassessment to demonstrate the resolution of the self-limited process. However, patients with extensive spread of infection or high risk of complications as a result of immunosuppression or other preexisting factors require a variety of treatment strategies such as antifungal therapy, surgical debridement, or both. Korea is not endemic area of a coccidioidomycosis. We report a case of disseminated coccidioidomycosis involving the lung and skin, which was detected incidentally after sunburn in a 69 year-old Korean male with diabetes mellitus and iatrogenic Cushings syndrome, with a review of the relevant literature.
Key Words: Coccidioidomycosis, Sunburn, Diabetes mellitus, Cushings syndrome

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