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Recurrent Coccidioidomycosis Manifesting as Osteomyelitis in Korea
Ji-hyeon Baek, M.D.1, Eun Young Park, M.D.1, Yoon Suk Jung, M.D.1, Jae Won Hong, M.D.1, Yuntae Chae, M.D.1, Sung Joon Jin, M.D.1, Hee Kyoung Choi, M.D.1, So Youn Shin, M.D.1, Sang Hoon Han, M.D.1, Bum Sik Chin, M.D.1, Chang Oh Kim, M.D.1, Jun Young Choi, M.D.1, Young Goo Song, M.D.1, Nam-Hoon Cho, M.D.2, and June Myung Kim, M.D.1
Departments of Internal Medicine1, Pathology2, Yonsei University College of Medicine, Seoul, Korea
Vol.41 Num.4 (p253~257)
Coccidioidomycosis is a fungal infection that results from inhaling the airborne arthroconidia of the Coccidioides species. It is an endemic disease in the southwest part of North America and rarely diagnosed in Korea. As tourism to endemic areas and the number of immunocompromised patients have been increasing, the incidence of this infection has increased in non-endemic areas. Treatment is usually successful with antifungal agents; however, recurrence is common. It is difficult to decide when to discontinue the antifungal treatment especially in non-endemic areas where doctors are not familiar with the disease. We report a case of recurrent coccidioidomycosis manifesting as osteomyelitis after the treatment of the patient for disseminated coccidioidal infection. The complement fixation test was a useful tool for the assessment of patient response and to evaluate suspected recurrence.
Keywords : Coccidioidomycosis, Recurrence, Osteomyelitis, Complement fixation test