Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Self-Assessment Questions

Infectious Diseases

Answer 5
  1. Coccidioidomycosis. The patient has pulmonary coccidioidomycosis. The history of recent travel to Arizona with exposure to a construction site is the key exposure history in this case. Most patients with coccidioidomycoses pneumonia have a self-limited course of illness; however, immunosuppressed patients (eg, patients with HIV) may have a fulminant course with respiratory failure. Some patients (commonly females) with coccidioidomycosis present with erythema multiforme or erythema nodosum. The triad of fevers, erythema nodosum, and arthralgias has been termed “desert rheumatism.” The patient is less likely to have pneumococcal pneumonia given her exposure history and bilateral diffuse infiltrates on chest radiograph. She has no history of exposure to blastomycosis. Her recent CD4 count of 350 cells/mm3 makes P. jiroveci pneumonia less likely.

    Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. 6th ed. New York: Elsevier/Churchill Livingstone; 2005.

Click here to return to the questions


Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 1/04/08 • kkj