More than Valley Fever: Pulmonary Actinomycosis and Coccidioidomycosis Co-infection in a Patient

Abuzar A Asif; Moni Roy; Sharjeel Ahmad

doi:10.12890/2021_002664

More than Valley Fever: Pulmonary Actinomycosis and Coccidioidomycosis Co-infection in a Patient

Eur J Case Rep Intern Med. 2021 Jul 1;8(7):002664. doi: 10.12890/2021_002664. eCollection 2021.

Authors

Abuzar A Asif¹, Moni Roy¹, Sharjeel Ahmad²

Affiliations

¹ Department of Internal Medicine, University of Illinois College of Medicine at Peoria, OSF Saint Francis Medical Center, Peoria, USA.
² Section of Infectious Diseases, University of Illinois College of Medicine at Peoria, OSF Saint Francis Medical Center, Peoria, USA.

Abstract

Pulmonary coccidioidomycosis and pulmonary actinomycosis are unheard of as co-pathogens. Infection with these organisms on their own can mimic lung cancer, thus presenting a diagnostic challenge. We present the case of a 75-year-old woman presenting with haemoptysis with a chest CT chest finding of a lung mass suggestive of lung cancer. A diagnosis of concomitant infection by Coccidioides posadasii/immitis and Actinomyces odontolyticus was made based on culture and histopathology results. The patient was successfully treated with a combination of antifungal and antibacterial therapy. This is the first reported case of co-infection by these two microorganisms.

Learning points: Pulmonary coccidioidomycosis and pulmonary actinomycosis can mimic lung cancer.The diagnosis of infection by Coccidioides posadasii/immitis and Actinomyces odontolyticus is best obtained by histopathology and tissue culture.Treatment comprises a combination of oral azoles and a beta-lactam antibiotic for a total of 12 months.

Keywords: Actinomyces; Coccidioides; actinomycosis; co-infection; coccidioidomycosis.