A 57-year-old patient with no previous diseases was admitted to hospital for dysarthria and right facial paralysis.
A cranial CAT scan was performed and later MRI showed a lesion occupying the left parieto-temporal space with large perilesional edema suggesting a neoplasic process.
The rest of the physical examination and initial complementary tests are normal, including chest X-ray.
The neurosurgical service suddenly presents dyspnea accompanied by desaturation, reason why she is admitted to the ICU where she needs mechanical ventilation.
Under suspicion of pulmonary thromboembolism, an urgent thoracic consolidation is performed in the posterior basal pulmonary parenchyma bilateral and multiple pulmonary nodules, as well as bilateral alveolar and interstitial infiltrate, all of them findings consistent with an infectious process.
Bronchial culture was obtained by bronchoalveolar lavage.
Due to the worsening of the patient despite broad-spectrum antibiotic therapy, a stereotactic biopsy of the brain lesion is performed with culture of the same.
In both cultures, isolated coccidioidomycosis was isolated.
HIV serology is negative.
The immune study was normal (CD3 65%, CD4 40%).
Despite treatment with vancomycin, amoxicillin and rifampicin, the patient died within 10 days of evolution.
