Downloads: 3 | Views: 79 | Weekly Hits: ⮙1 | Monthly Hits: ⮙3

Case Studies | Medicine | India | Volume 12 Issue 2, February 2023

Cutaneous Coccidioidomycosis in India - Report of Second Imported Case from USA

Naveen A S | PSenthur Nambi | Ram Gopalakrishnan | V Ramasubramanian | N Geetha

Abstract: A young Indian male presented with non - healing ulcerative lesion over the left pre auricular area with cervical lymphadenopathy since 1 year. It did not resolve despite regular treatment with anti tuberculous therapy for 6 months based on the previous biopsy specimen showing evidence of granulomas. He did not have any significant medical comorbidities or high risk behaviours. He had travelled to Arizona, USA for pilot training programme and had stayed there for 8 months with significant outdoor exposure visiting national parks and canyons. With this strong epidemiological link possibility of endemic mycosis was considered and patient was advised for repeat biopsy from the lesion, but the patient was not willing for the same. Careful histopathological slide review of the original biopsy specimen and fungal stains by our institution pathologist showed suppurative granulomatous inflammation with spherules consistent with coccidioidomycosis. He was started on Itraconazole and he started to show clinical improvement. After 4 months of treatment, due to hyperbilirubinemiaitraconazole was changed to fluconazole and 8 months of treatment was completed.

Keywords: Coccidioidomycosis, Endemic mycosis, Fungal infection, Granulomatous infection, Skin infection

Edition: Volume 12 Issue 2, February 2023,

Pages: 245 - 247