Valley Fever in the UK? - The importance of a travel history

Abstract

Summary

Coccidioidomycosis, also known as Valley Fever, is a fungal infection caused by the inhalation of spores, and is endemic in the Southwestern United States; regions of Mexico, Central America and South America.¹ It therefore came as a surprise to isolate this infection from a patient in a seaside town in North Yorkshire, UK. Coccidioidomycosis is caused by either Coccidioides immitis or Coccidioides posadasii, and once inhaled they are highly infectious, and can cause a wide variation in clinical manifestation and imaging findings.1 Most infections primarily involve the lungs, and are self-limiting and resolve over a period of weeks to months.² Occasionally the infection can spread to cause a very serious disseminated disease. The radiographic findings can be nonspecific and variable, often raising concern for many differential diagnoses such as malignancy, other infections or granulomatous conditions.^1,3

Relevance

This was an interesting case of a female patient in the UK presenting with nonspecific respiratory symptoms, and eventually being diagnosed with a fungal infection typically found in the Southwestern United States.

Take Home Messages

It highlights the importance of enquiring about a travel history, and conducting appropriate imaging, even when the initial picture points towards a less exotic, more sinister diagnosis.