A 45-year-old African-American man from Georgia was in good health until 2 months ago when he developed a low grade fever, myalgia, and a non-productive cough. On admission to the hospital, he was feverish, had breathing difficulties, and stated he had lost 5 pounds in weight over the past 2 months. The patient tested as HIV-negative, had not traveled recently, and was a non-smoker. He worked as a gardener for a local city park. A chest X-ray showed that the patient had consolidation of the middle lobe of his right lung with a small TB-like mass at the same location. An observant physician also noticed that the patient had a raised lesion on the bridge of the nose, which was tender to the touch. Bronchoscopy yielded a biopsy sample, which contained a large, round, budding yeast. Culture of the yeast yielded an ascomycete producing numerous macro- and microconidia. What fungal disease is this patient suffering from ?
Coccidioidomycosis - based on the symptoms it can be concluded that coccidioidomycosis is the disease. It is caused by Coccidioides immitis, a dimorphic fungi. The symptoms of the disease include feeling of tiredness, fever, non-productive cough, headaches, rash, muscle pain (myalgia), and joint pain. The fungi can create a mass in the lungs that resembles a lung tumor and lesions on the skin. Correct diagnosis always requires a biopsy and culturing the fungi under special precautions.
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