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Clinical Problem Solving: Pathology
June 2009

Pathology Quiz Case 1: Diagnosis

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Copyright 2009 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2009

Arch Otolaryngol Head Neck Surg. 2009;135(6):618-619. doi:10.1001/archoto.2009.41-b

Coccidioidomycosis, which is caused by Coccidioides immitisor Coccidioides posadasii, is a disease that affects both immunocompetent and immunocompromised individuals.1Infectious airborne spores known as arthroconidiaare inhaled by the host and reach the pulmonary alveoli. Approximately 60% of individuals with primary coccidioidomycosis are asymptomatic. Most of the remaining 40% experience mild to moderate symptoms within 7 to 21 days after inhalation of arthroconidia. Common symptoms include fever, cough, chest discomfort, headache, malaise, and fatigue.13Other pulmonary manifestations include pneumonia, pleural effusion, hilar lymphadenopathy, and lung nodules.1,2

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