Coccidioidomycosis Lymphadenitis in a patient with Lupus nephritis: A case report

IF 1.8 4区医学 Q3 MYCOLOGY

Journal de mycologie medicale Pub Date : 2025-06-07 DOI:10.1016/j.mycmed.2025.101559

Gustavo Abraham Canales-Azcona , Abraham Castellanos-Maldonado , Héctor Raúl Ibarra-Sifuentes , Yadhira María González-Amador

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引用次数: 0

Abstract

Coccidioidomycosis is a fungal infection endemic to arid regions. Although it usually presents as a pulmonary infection, extrapulmonary dissemination is rare, and cervical lymphadenitis is even more unusual with fewer than five cases reported in the literature. Diagnosis of this disease remains a clinical challenge due to its rarity and similarity to other clinical entities. A 34-year-old woman with lupus nephritis on immunosuppressive therapy presented with a painful cervical mass associated with unquantified fever of six weeks of evolution. The patient is a resident of Coahuila, Mexico, in a region adjacent to the Texas–Mexico border. Diagnostic imaging and excisional biopsy with histopathology and culture confirmed cervical lymphadenitis due to Coccidioides. Treatment with oral fluconazole (Diflucan) was started, achieving complete clinical resolution after 12 months. This case highlights the importance of considering different fungal infections in immunocompromised patients presenting with lymphadenopathy. Early diagnosis by biopsy and culture, as well as specific antifungal treatment are essential to obtain favorable results.

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狼疮性肾炎伴球孢子菌性淋巴结炎1例报告

球孢子菌病是干旱地区特有的一种真菌感染。虽然它通常表现为肺部感染，但肺外播散是罕见的，宫颈淋巴结炎更不寻常，文献中报道的病例不到5例。由于其罕见性和与其他临床实体的相似性，这种疾病的诊断仍然是一个临床挑战。34岁女性狼疮性肾炎患者接受免疫抑制治疗，表现为疼痛的宫颈肿块伴6周的发热。患者是墨西哥科阿韦拉的居民，该地区毗邻德克萨斯-墨西哥边境。诊断影像及组织病理学及培养的切除活检证实为球虫引起的宫颈淋巴结炎。开始口服氟康唑（大氟康）治疗，12个月后临床完全痊愈。本病例强调了考虑不同真菌感染的重要性免疫功能低下的患者表现为淋巴结病。早期诊断活检和培养，以及特异性抗真菌治疗是必不可少的，以获得良好的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal de mycologie medicale 医学-真菌学

CiteScore

5.10

自引率

2.80%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal de Mycologie Medicale / Journal of Medical Mycology (JMM) publishes in English works dealing with human and animal mycology. The subjects treated are focused in particular on clinical, diagnostic, epidemiological, immunological, medical, pathological, preventive or therapeutic aspects of mycoses. Also covered are basic aspects linked primarily with morphology (electronic and photonic microscopy), physiology, biochemistry, cellular and molecular biology, immunochemistry, genetics, taxonomy or phylogeny of pathogenic or opportunistic fungi and actinomycetes in humans or animals. Studies of natural products showing inhibitory activity against pathogenic fungi cannot be considered without chemical characterization and identification of the compounds responsible for the inhibitory activity. JMM publishes (guest) editorials, original articles, reviews (and minireviews), case reports, technical notes, letters to the editor and information. Only clinical cases with real originality (new species, new clinical present action, new geographical localization, etc.), and fully documented (identification methods, results, etc.), will be considered. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey platforms.