Tuberculosis and coccidiodomycosis in two patients without immune acquired deficiency

Alicia Guadalupe Silva-Hernández; Enrique Barbachano-Rodríguez; Pamela Alejandra Alanís-Miranda; Marisela del Rocío González-Martínez; Arnulfo Portales-Castanedo

2010, Number 4

<< Back Next >>

Rev Med Inst Mex Seguro Soc 2010; 48 (4)

Tuberculosis and coccidiodomycosis in two patients without immune acquired deficiency

Silva-Hernández AG, Barbachano-Rodríguez E, Alanís-Miranda PA, González-Martínez MR, Portales-Castanedo A

Full text

How to cite this article

Language: Spanish
References: 14
Page: 447-452
PDF size: 69.80 Kb.

ABSTRACT

Coccidioidomycosis results from inhaling the spores (arthroconidia) of Coccidioides species (Coccidioides immitis or Coccidioides posadasii). Tuberculosis is caused by the Mycobacterium tuberculosis complex, classified as acid-fast bacilli. It is most commonly transmitted from a patient with infectious pulmonary tuberculosis to other persons by droplet nuclei, which are aerosolized by coughing, sneezing, or speaking. Northern Mexico is an endemic zone for coccidioidomycosis and Tuberculosis, both diseases usually appear in an isolated way, however, in cases of immunosuppressant in endemic zones, both pathologies tend to coexist. In all of the cases, determining the correct diagnosis is very difficult because they share epidemiological, clinical, radiographic, and even histopathological characteristics. In this paper we present two cases of tuberculosis and coccidioidomycosis coexistence. One case presented pulmonary disease from both entities, while the other was a relapsing of disseminated coccidioidomycosis associated with systemic tuberculosis. The presence of similar cases should alert the clinician to consider an early diagnosis of both entities in every patient with compatible clinical features. The most important concept is to remember that the diagnosis of one of them, doesn’t exclude the possible existence of the other.

REFERENCES

Galgiani JN, Ampel NM, Blair JE, Catanzaro A, Johnson RH, Stevens DA, et al. Coccidioidomycosis. Clin Infect Dis 2005;41(9):1217-1223.
Castañón-Olivarez L, Aroch-Calderón A, Bazán- Mora E, Córdova-Martínez E. Coccidioidomicosis y su escaso conocimiento en nuestro país. Rev Fac Med UNAM 2004;47(4):145-148. Disponible en http://www.revistafacmed.com/2004/ JulioAgosto/un044d.pdf
Castañón-Olivarez LR, Güereña-Elizalde D, González- Martínez MR, Licea-Navarro AF, González- González GM, Aroch-Calderón A. Molecular identification of coccididoides isolates from Mexican patients. Ann NY Acad Sci 2007:1111:326-335.
Padua-Gabriel A, Martínez-Ordaz VA, Velazco- Rodriguez V, Lazo-Sáenz JG, Cicero R. Prevalence of skin reactivity to coccidioidin and associated risks factors in subjects living in a Northern city of Mexico. Arch Med Res 1999;30(5):388-392.
Stevens D. Coccidioidomycosis. N Engl J Med 1995;332(16):1077-1082.
Rabiglione M, O´Brien R. Tuberculosis. En: Kasper D, Braunwald E, Fauci A, editores. Harrison: principios de medicina interna. México: McGraw-Hill; 2005. p. 1062-1076.
Castañeda-Godoy R, Laniado-Laborín R. Coexistencia de tuberculosis y coccidioidomicosis. Presentación de dos casos clínicos. Rev Inst Nal Enf Resp Mex 2002;15(2):98-101. Disponible en http://www. medigraphic.com/pdfs/iner/in-2002/ in022h.pdf
Laniado-Laborín R. Coccidioidomicosis, más que una enfermedad regional. Rev Inst Nal Enf Resp Mex 2006;19(4):301-308. Disponible en http:// www.scielo.org.mx/pdf/iner/v19n4/v19n4a14.pdf
Fraser R, Paré P. Micobacterias. En: Fraser R, Müller N, Colman N, editores. Diagnóstico de las enfermedades del tórax. Cuarta edición. Buenos Aires: Médica Panamericana; 2002. p. 790.
Kirkland T, Fierer J. Coccidioidomycosis: a reemerging infectious disease. Emerg Infect Dis 1996;3 (2):192-199. Disponible en http://www.ncbi.nlm. nih.gov/pmc/articles/PMC2626789/pdf/8903229. pdf
Ortiz-Gonzales J, Reyes-Segura MP, Sánchez- Lozada R, Basurto-Kuba EOP. Tuberculosis gastrointestinal. Cir Gen 2002;42(1):66-71.
Crump JA, Reller LB. Two decades of disseminated tuberculosis at a university medical center: the expanding role of mycobacterial blood culture. Clin Infect Dis 2003;37(8):1037-1043.
Clement S, Braithwaite SS, Magee MF, Ahmann A, Smith EP, Schafer RG, et al. Management of diabetes and hiperglycemia in hospitals. Diabetes Care 2004;27(2):553-591. Disponible en http://care. diabetesjournals.org/content/27/2/553.long
Martinez-Delgado J, Trujillo-Lara R, Padua-Gabriel A, González-Martínez Marisela, Manríquez-Covarrubias L. Coccidioidomicosis pulmonar. Tratamiento quirúrgico de dos casos. Gac Med Mex 1993; 129(1):53-56.