Coccidioidomycosis and Pulmonary Emboli: A Report of 5 Cases

05 July 2020: Articles

Challenging differential diagnosis, Management of emergency care, Rare coexistence of disease or pathology

John G. Prichard ^B* , Michelle B. Azimov ^B , Karlos Z. Oregel ^B

DOI: 10.12659/AJCR.924179

Am J Case Rep 2020; 21:e924179

Table 1. Tabular summary of 5 cases of coccidioidomycosis with pulmonary emboli.

Case	Age	Sex	Ethnicity	Location of infection	Complement fixation titer at diagnosis	Cocci treatment	Pulmonary emboli (PE) location	VTE treatment	VTE risk factors
1	37	F	Latino	Pneumonia (LLL)	1: 16	Anti-fungal	Bilateral lower lobe and RML of lung	DOAC	Cardiolipin antibodies positive; obesity; travel prior to PE
2	63	M	Latino	Pneumonia (LLL)	1: 32	None	Saddle Emboli	DOAC	Transient positive anticardiolipin antibodies; obesity; splenectomy
3	42	F	Latino	Pneumonia (RUL)	1: 2	Anti-fungal	RLL of lung	DOAC	Negative hypercoagulable evaluation
4	45	M	Latino	CNS (basilar cisterns), pneumonia, skin	1: 64	Anti-fungal	LLL, RLL, RML, RUL of lung	DOAC	Recent hospitalization (2 weeks after cocci diagnosis)
5	35	M	Latino	Pneumonia (RUL, RML, RLL)	1: 32	Anti-fungal	LLL of lung	DOAC	Tibial and left peroneal veins DVT; obesity
Cocci – Coccidioidomycosis; VTE – venous thromboembolism; LLL – left lower lobe; DOAC – direct acting oral anticoagulant; RUL – right upper lobe; RLL – right lower lobe; CNS – central nervous system; RML – right middle lobe; DVT – deep vein thrombosis.