05 July 2020
: Case report 
Coccidioidomycosis and Pulmonary Emboli: A Report of 5 Cases
Challenging differential diagnosis, Management of emergency care, Rare coexistence of disease or pathology
John G. Prichard1BEF*, Michelle B. Azimov23BEF, Karlos Z. Oregel2BEDOI: 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. | |||||||||