Fatal coccidioidomycosis involving the lungs, brain, tongue, and adrenals in a cirrhotic patient. An autopsy case

David Chee, August W. Moritz, Amanda P. Profit, Apeksha N. Agarwal, Gregory M. Anstead

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5 Scopus citations

Abstract

In this paper, we describe a case of fatal disseminated coccidioidomycosis (CM). The patient was a 44-year old male with a history of cirrhosis who presented with altered mental status, cough, and an enlarged, ulcerated tongue. On evaluation, the patient was found to have coccidioidal infection of the tongue, lungs, and brain. Despite over two months of antifungal treatment, the patient died from aspiration pneumonia and at autopsy was found to have persistent infection of the tongue and lungs, extensive mycosis of the brain, and involvement of both adrenal glands. The fulminant course of coccidioidomycosis in this patient is ascribed to his baseline cirrhosis and lymphocytopenia. There are few autopsy cases of CM that have been described in the post-antifungal era and few published cases of CM with either tongue or adrenal involvement.

Original languageEnglish (US)
Article numbere01049
JournalIDCases
Volume23
DOIs
StatePublished - Jan 2021

Keywords

  • Adrenals
  • Autopsy
  • Brain
  • Cirrhosis
  • Coccidioidomycosis
  • Lungs
  • Tongue

ASJC Scopus subject areas

  • Infectious Diseases

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