{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:51:19Z","timestamp":1782489079353,"version":"3.54.5"},"reference-count":22,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"unspecified","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,3,20]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>Coccidioidomycosis is endemic to the Western Hemisphere and is rarely encountered in Asia, including Thailand. A detailed history, particularly of prior travel to endemic areas, is critical in refining the differential diagnosis and considering coccidioidomycosis.<\/jats:p>\n                  <jats:p>Here, we report an early adolescent male who presented with fever, non-productive cough and pleuritic chest pain of 1 month\u2019s duration. Radiologic findings were suggestive of pulmonary tuberculosis. Antituberculosis therapy was started, but there was no clinical improvement. However, on specific questioning, we learned that he had recently returned from Los Angeles, USA, before the onset of the illness. Hence, pulmonary coccidioidomycosis was suspected based on his travel history to an endemic region and the recognition that its clinical presentation can closely mimic tuberculosis. The diagnosis was confirmed by the results of pathology, cultures and molecular methods of transbronchial lung biopsy specimens. The patient gradually improved after fluconazole treatment.<\/jats:p>","DOI":"10.1136\/bcr-2025-271476","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T13:20:15Z","timestamp":1776864015000},"page":"e271476","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Coccidioidomycosis in Thailand: a diagnostic challenge in a non-endemic country"],"prefix":"10.1136","volume":"19","author":[{"given":"Chaianant","family":"Leelabooranasak","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Division of Infectious Diseases, Department of Internal Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kulchamai","family":"Silathapanasakul","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuntanuj","family":"Vutthikraivit","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arsa","family":"Thammahong","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Chulalongkorn University, Bangkok, Thailand"},{"name":"Center of Excellence in Antimicrobial Resistance and Stewardship, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thitiwat","family":"Sriprasart","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chusana","family":"Suankratay","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Division of Infectious Diseases, Department of Internal Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"2026062608154604000_19.4.e271476.1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02230-06"},{"key":"2026062608154604000_19.4.e271476.2","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.idc.2024.11.012","article-title":"Coccidioidomycosis","volume":"39","author":"Donovan","year":"2025","journal-title":"Infect Dis Clin North 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