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A Case of Concurrent Disseminated Coccidioidomycosis and Embryonal Carcinoma When Lice and Fleas Coexist

Authors
  • Ke, Michael1, 2
  • Heidari, Arash1, 2
  • Valdez, Michael3
  • Tsiyer, Allen3
  • Kuran, Rasha1, 2
  • Johnson, Royce1, 2
  • 1 Department of Internal Medicine, Division of Infectious Diseases, UCLA at Kern Medical Center, Bakersfield, CA, USA
  • 2 Valley Fever Institute, Bakersfield, CA, USA
  • 3 Department of Internal Medicine, UCLA at Kern Medical Center, Bakersfield, CA, USA
Type
Published Article
Journal
Journal of Investigative Medicine High Impact Case Reports
Publisher
SAGE Publications
Publication Date
May 13, 2022
Volume
10
Identifiers
DOI: 10.1177/23247096221098339
PMID: 35567302
PMCID: PMC9109491
Source
PubMed Central
Keywords
Disciplines
  • Case Report
License
Unknown

Abstract

Coccidioidomycosis (CM) is a fungal infection endemic to the southwestern United States with a wide range of clinical presentations depending on the infected organ systems. Most infections are asymptomatic. Coccidioidomycosis causes a primary pulmonary infection and when symptoms occur, they most often resemble community-acquired pneumonia. One percent of cases disseminate, typically via hematogenous or lymphatic spread. It is in these cases that more severe symptoms may present and potentially overlap with those characteristics of other systemic illnesses. This is a case of CM disseminated to lymph nodes in a 24-year-old man with concomitant metastatic embryonal carcinoma. It is difficult to identify the primary etiology for many components of this patient’s presentation, including diffuse lymphadenopathy and multiple pulmonary nodules. Furthermore, the relationship between these 2 concurrent disease processes is not entirely clear. Factors that may contribute include the well-known phenomenon of locus minoris resistentiae (LMR) or potentially a shared immune failure between infectious organisms and malignant cells.

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