당뇨와 의인성 쿠싱 증후군 환자에서 폐와 피부 에 병발한 콕시디오이데스 진균증
A Case of Disseminated Coccidioidomycosis Involving Lung and Skin in Patient with Diabetes Mellitus and Iatrogenic Cushings Syndrome
현인규 (한림대학교)
정기석 (한림대학교)
이일성 (한림대학교)
김철홍 (한림대학교)
손광표 (한림대학교)
김진경 (한림대학교)
변현우 (한림대학교)
김영순 (한림대학교)
정인경 (한림대학교)
우흥정 (한림대학교)
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Abstract
Coccidioidomycosis is caused by a dimorphous fungus, Coccidioides, which consists of two species, C. immitis and C. posadasii. Although these organisms are genetically distinct and do not exchange DNA, they appear identical phenotypically and the disease or immune response to the organisms is also identical. Coccidioides grows as a mycelium in the soil and is mainly found in Southwestern United States, northwestern Mexico, and Argentina. An infection usually results from inhaling the spores of the fungus in an endemic area. Patients with a localized infection and no risk factors for complications often require only a periodic reassessment to demonstrate the resolution of the self-limited process. However, patients with extensive spread of infection or high risk of complications as a result of immunosuppression or other preexisting factors require a variety of treatment strategies such as antifungal therapy, surgical debridement, or both. Korea is not endemic area of a coccidioidomycosis. We report a case of disseminated coccidioidomycosis involving the lung and skin, which was detected incidentally after sunburn in a 69 year-old Korean male with diabetes mellitus and iatrogenic Cushings syndrome, with a review of the relevant literature. (Tuberc Respir Dis 2005; 58: 399-403)
- keywords
- Coccidioidomycosis, Sunburn, Diabetes mellitus, Cushings syndrome
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