{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:40:15Z","timestamp":1756309215536,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,9,12]]},"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:p>An elderly man without history of travel presented with complaints of intermittent fever for 2 months, cough with scanty expectoration for 15 days and history of weight loss of 5 kg in 1\u2009year. The chest X-ray and CT scan of the thorax showed dispersed centrilobular nodules and patchy subpleural consolidation in both lungs with mediastinal lymphadenopathy. He underwent bronchoscopy and bronchoalveolar lavage culture grew <jats:italic>Pseudomonas aeruginosa<\/jats:italic>. He was prescribed antibiotics based on culture sensitivity; however, patient continued to have symptoms. All relevant blood investigations were within normal limits. He underwent CT-guided biopsy of the right lung lesion during which clearing of the radio-opacities present in the initial CT scan and appearance of fresh lesions in different locations were observed. Migratory shadows were suspected. Fine-needle aspiration cytology showed features suggestive of coccidioidomycosis for which antifungals were started. After 1\u2009month, he improved symptomatically and chest X-ray showed clearance of shadows.<\/jats:p>","DOI":"10.1136\/bcr-2021-248711","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T11:51:53Z","timestamp":1663674713000},"page":"e248711","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Coccidioidomycosis where you least expect it"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6821-4043","authenticated-orcid":false,"given":"Nandu","family":"Nair","sequence":"first","affiliation":[{"name":"Pulmonary Medicine, KS Hegde Medical Academy, Mangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7812-3508","authenticated-orcid":false,"given":"Nandakishore","family":"Baikunje","sequence":"additional","affiliation":[{"name":"Pulmonary Medicine, KS Hegde Medical Academy, Mangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giridhar Belur","family":"Hosmane","sequence":"additional","affiliation":[{"name":"Pulmonary Medicine, KS Hegde Medical Academy, Mangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil","family":"Kumar","sequence":"additional","affiliation":[{"name":"Pathology, KS Hegde Medical Academy, Mangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,9,20]]},"reference":[{"key":"2025082708131836000_15.9.e248711.1","doi-asserted-by":"crossref","first-page":"387","DOI":"10.20452\/pamw.426","article-title":"Coccidioidomycosis in a 38-year-old man: a case report","volume":"118","author":"Batura-Gabryel","year":"2008","journal-title":"Pol Arch Med Wewn"},{"key":"2025082708131836000_15.9.e248711.2","doi-asserted-by":"crossref","first-page":"580","DOI":"10.11150\/kansenshogakuzasshi1970.74.580","article-title":"[An imported case of primary pulmonary coccidioidomycosis]","volume":"74","author":"Futsuki","year":"2000","journal-title":"Kansenshogaku Zasshi"},{"key":"2025082708131836000_15.9.e248711.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2008.01232.x"},{"key":"2025082708131836000_15.9.e248711.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2008.01407.x"},{"key":"2025082708131836000_15.9.e248711.5","first-page":"353","article-title":"Pulmonary coccidioidomycosis: import illness and the importance of travel history","volume":"67","author":"Indhirajanti","year":"2009","journal-title":"Neth J Med"},{"key":"2025082708131836000_15.9.e248711.6","doi-asserted-by":"publisher","DOI":"10.1631\/jzus.B1000261"},{"key":"2025082708131836000_15.9.e248711.7","doi-asserted-by":"publisher","DOI":"10.1053\/rmed.2000.1039"},{"key":"2025082708131836000_15.9.e248711.8","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1080\/mmy.40.3.307.309","article-title":"Coccidioidomycosis in India: report of a second imported case","volume":"40","author":"Verghese","year":"2002","journal-title":"Med Mycol"},{"key":"2025082708131836000_15.9.e248711.9","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.mycmed.2010.11.004","article-title":"Coccidioidomycosis in India: report of a third imported case","volume":"21","author":"Savio","year":"2011","journal-title":"J Mycol Med"},{"key":"2025082708131836000_15.9.e248711.10","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1007\/s15010-012-0315-9","article-title":"Pulmonary coccidiomycosis in New Delhi, India","volume":"40","author":"Oberoi","year":"2012","journal-title":"Infection"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-248711","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:13:26Z","timestamp":1756307606000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-248711"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9]]},"references-count":10,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9,20]]},"published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1136\/bcr-2021-248711"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-248711","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2022,9]]}}}