Surgical Resection to Treat a Japanese Patient with Pulmonary Coccidioidomycosis

Takashi Abe,1,* Fumihiro Yamaguchi,1,* Shunsuke Sakakura,1 Yo Shiratori,1 Ayaka Mase,1 Toshitaka Funaki,1 Yoshito Kamio,2 Takashi Suzuki,2 Yusuke Shikama,1 Yasutaka Hoshino3 1Department of Respiratory Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan; 2Departments of Thoracic Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan; 3Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan*These authors contributed equally to this workCorrespondence: Fumihiro Yamaguchi, Department of Respiratory Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, 227-8501, Japan, Tel +81-45-971-1151, Email f_y@med.showa-u.ac.jpAbstract: Coccidioidomycosis is an endemic disease that is particularly prevalent in the United States. However, its geographic distribution is becoming widespread. Here, we present a Japanese male who resided in the United States for 1 year, where he was diagnosed with pulmonary coccidioidomycosis that was accompanied by cavity formation. He did not tolerate antifungal therapy and consequently underwent partial resection of the upper lobe of his left lung upon his return to Japan. The patient’s symptoms improved after surgery. The trend toward global networking and logistics means that a diagnosis of coccidioidomycosis should be considered in routine practice in nonendemic areas. Due to the rarity of surgical treatment for this disease, prolonged follow-up is necessary. During the last follow-up, the patient was symptom-free.Keywords: coccidioidomycosis, Coccidioides immitis, Coccidioides posadasii, endemic disease