초록
우리나라는 콕시디오이데스 진균증의 유행지역이 아니기 때문에 유행지역에 대한 해외여행자나 이민거주자가 아니면 임상적으로 의심하기가 쉽지 않다. 저자들은 해외여행력과 이민거주자가 아닌 내국인으로 당뇨와 의인성 쿠싱 증후군을 오랫동안 간과해 왔던 상태에서 일광화상 후 생긴 피부상처 치료도중 우연히 파종성 콕시디오이데스 진균증을 진단하게 되었기에 문헌고찰과 함께 보고하는 바이다.
Coccidioidomycosis is caused by a dimorphous fungus, Coccidioides, which consists of two species, C. immitis and C. posadasii. Although these organisms are genetically distinct and do not exchange DNA, they appear identical phenotypically and the disease or immune response to the organisms is also identical. Coccidioides grows as a mycelium in the soil and is mainly found in Southwestern United States, northwestern Mexico, and Argentina. An infection usually results from inhaling the spores of the fungus in an endemic area. Patients with a localized infection and no risk factors for complications often require only a periodic reassessment to demonstrate the resolution of the self-limited process. However, patients with extensive spread of infection or high risk of complications as a result of immunosuppression or other preexisting factors require a variety of treatment strategies such as antifungal therapy, surgical debridement, or both. Korea is not endemic area of a coccidioidomycosis. We report a case of disseminated coccidioidomycosis involving the lung and skin, which was detected incidentally after sunburn in a 69 year-old Korean male with diabetes mellitus and iatrogenic Cushings syndrome, with a review of the relevant literature.
