ELLIOT GOLDSTEIN, M. D.
Infection with Coccidioides immitis classically causes segmental or lobar pneumonias, and, in instances of dissemination, the extrapulmonary illness follows insidiously, often appearing so long after the primary pulmonary infection as to seem unrelated to it (1). As a result, disseminated coccidioidomycosis is frequently unsuspected in its earliest stages. Recently, we cared for a patient who developed rapidly fatal coccidioidomycosis with meningoencephalitis, which disseminated from a primary miliary pneumonia. We suggest that the finding of miliary coccidioidomycosis should alert the clinician to the possibility of disseminated disease.
A 35-year-old white man with insulin-dependent diabetes (40 U NPH/day) was exposed to arthroconidia
GOLDSTEIN E. Miliary and Disseminated Coccidioidomycosis. Ann Intern Med. 1978;89:365–366. doi: 10.7326/0003-4819-89-3-365
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Published: Ann Intern Med. 1978;89(3):365-366.
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