Rosales MGF, Rodríguez GA, Becerra CED

Language: Spanish
References: 11
Page: 138-142
PDF size: 964.76 Kb.

ABSTRACT

Coccidioides sp. infections have different clinical manifestations. Pulmonary infections is considered the most common. Osteoarticular infection in a previously healthy adolescent is presented.
Clinical case. A healthy 14-year-old male, started a previous month with an increase in volume on the inside of his right elbow, with erythema and discharge of odorless hyaline fluid due to fistula, limited mobility and moderate intensity pain, denied weight loss and fever. He was evaluated by an orthopedist, who requested imaging and biopsy studies. Chronic granulomatous inflammation, necrotic area with surrounding multinucleated cells and mature spherules with inside endospores, suggestive of infection by Coccidioides sp., was reported. No intradermal reaction was performed, histopathology studies confirmed fungus presence. Amphotericin b lipid complex was prescribed and subsequent change to itraconazole 400 mg orally, with favorable evolution.
Discussion. Joints are frequent sites of disseminated Coccidioides sp. infections. Real incidence in Mexico is unknown. Infection can occur at any age. Diagnosis is established with the fungus demonstration by culture or histopathology. Success in the treatment implies an early diagnosis.

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