COCCIDIOIDOMYCOSIS CAUSING GRANULOMATOUS HEPATITIS

The case of 36-year-old man is reported who fell ill with a febrile in fection, shortly after returning from several weeks to Mexico. Examina tion: Chest X-ray revealed a pulmonary infiltration. Also, the levels of liver function tests (gamma-GT, alkaline phosphatase, SGOT, SGPT) w ere clearly increased. As there were no signs of extended bile ducts i n ultrasonics, a liver biopsy was indicated. The histology showed a gr anulomatous hepatitis. Diagnosis: The exposure during the Mexico-trip, the pulmonary infiltration, the histology and the significant raised titers in specific serological tests led to the diagnosis of a general infection by the fungus coccidioides immitis. In addition to pathogen etic aspects of coccidioidomycosis the diagnostic approaches and relev ant therapeutic strategies are discussed.