Medical image of the week: valley fever cavity with fungus ball

Southwest Journal of Pulmonary and Critical Care

Robbins RA¹ 

[1] Phoenix Pulmonary and Critical Care Research and Education Foundation, Gilbert, AZ USA;

关键词: coccioidomycosis;    valley fever;    fungus ball;    cavity;    thin walled;    aspergilloma;    hemoptysis;    treatment;    CT scan;    fluconazole;   

DOI  :  10.13175/swjpcc064-18

来源: DOAJ

【 摘 要 】

No abstract available. Article truncated at 150 words. A 72-year-old man was seen in 2010 because of hemoptysis. In 2004 a routine chest x-ray discovered a new pulmonary nodule (Figure 1, Figure 2A). Coccioidomycosis by complement fixation and IgM were negative but IgG was elevated at 0.203 (upper limit of normal 0.150).A transthoracic needle biopsy revealed a granuloma without malignancy and no growth of any organisms. He was followed because he was asymptomatic. He remained asymptomatic but developed a thin-walled cavity (Figure 2B). However, beginning in 2008 he developed a cough with occasional hemoptysis. His thoracic CT scan was repeated and was interpreted as showing findings consistent with a fungus ball (Figure 2C). He was treated with fluconazole for about 6 months but his hemoptysis persisted and therapy was switched to itraconazole. His hemoptysis persisted although it was somewhat improved. A repeat CT scan performed in 2010 (Figure 2D) continued to show the fungus ball. He was …

【 授权许可】

Unknown