BMJ Case Reports 2012; doi:10.1136/bcr-2012-006706
  • Rare disease

An unusual cause of a pulmonary opacity in a visitor to the UK

  1. Simon William Dubrey
  1. Department of Cardiology, Hillingdon Hospital, Uxbridge, Middlesex, UK
  1. Correspondence to Dr Simon William Dubrey, simon.dubrey{at}

A 64-year-old man, resident in Arizona for 3 years, presented with a week-long history of a dry cough and ‘flu-like symptoms’. He had recently been renovating his house. A chest radiograph showed a left mid-zone opacity. Investigations for lung cancer were performed and he underwent CT-guided biopsy of the lesion. A coccidioidal fungus known to cause ‘Valley Fever’ was isolated. Treatment with fluconazole led to a complete recovery. This fungal infection is endemic in parts of the USA and Mexico and usually presents with respiratory symptoms. Additional complications include disseminated disease and meningitis.


  • Competing interests None.

  • Patient consent Obtained.

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