A fluffy white traveller: Imported Coccidiodes immitis infection in an Australian tourist

Pulmonary coccidioidomycosis is a rare cause of pulmonary nodules and respi ratory infection in travellers to endemic areas. An Australian tourist suff ered an acute respiratory illness while on holiday in Mexico. She subsequen tly developed erythema nodosum and was noted to have a left pulmonary nodul e on chest X-ray after return to Australia. The diagnosis of Coccidioides i mmitis infection was established by histology and culture of the resected l ung lesion. The patient made an uneventful recovery and received one month of therapy with ketoconazole. Culture of the fungus took place under contro lled Class 3 conditions. An unusual fungal infection in Australia, coccidio idomycosis poses special risks to staff of microbiology laboratories.