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Coccidioidomycosis with cutaneous manifestation of erythema nodosum in Taiwan
Chien-Ming Chen, Hua-En Lee, Shu-Ying Li
DERMATOLOGICA SINICA 28 (2010) 154–158

Coccidioidomycosis is a fungal disease endemic to the southwestern USA, northern
Mexico, and focal areas in Central and South America, but it is rarely reported in
Taiwan. We report a case of coccidioidomycosis of probable pulmonary origin in a
young woman, who came back to Taiwan after a 10-month stay in the Central Valley of
California. Coccidioidomycosis was suspected by typical constellation of symptoms
and signs of Valley fever and subsequent desert rheumatism. The diagnosis was confirmed
by positive results of latex agglutination, immunodiffusion tube precipitation
and immunodiffusion complement fixation tests. We prescribed symptomatic treatment
without any anti-fungal agent according to the Infectious Disease Society of America
guidelines, and the clinical symptoms and signs gradually subsided 3 weeks later.
Although coccidioidomycosis is rare in Taiwan, it is believed that the real incidence
has been underestimated. Clinicians must be familiar with the typical manifestations
and consider the diagnosis of coccidioidomycosis when an individual presents with
fever, cough, arthralgia and skin eruptions such as erythema nodosum and/or erythema
multiforme with a traveling history to the endemic area.

   
   
 
 
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