First imported coccidioidomycosis in Turkey: A potential health risk for laboratory workers outside endemic areas

A Serda Kantarcioglu; M Sandoval-Denis; Gokhan Aygun; Nuri Kiraz; Canan Akman; Hulya Apaydin; Emin Karaman; Josep Guarro; G Sybren de Hoog; M S Gurel

doi:10.1016/j.mmcr.2014.01.002

First imported coccidioidomycosis in Turkey: A potential health risk for laboratory workers outside endemic areas

Med Mycol Case Rep. 2014 Jan 20:3:20-5. doi: 10.1016/j.mmcr.2014.01.002. eCollection 2014 Jan.

Authors

Affiliations

¹ Cerrahpasa Medical Faculty, Department of Medical Microbiology, Deep Mycosis Laboratory, Istanbul University, Istanbul 34098, Turkey.
² Unitat de Microbiologia, Facultat de Medicina i Ciencies de la Salut, IISPV, Universitat Rovira i Virgili, 43201 Reus, Spain.
³ Cerrahpasa Medical Faculty, Department of Radiology, Istanbul University, Istanbul 34098, Turkey.
⁴ Cerrahpasa Medical Faculty, Department of Neurology, Istanbul University, Istanbul 34098, Turkey.
⁵ Cerrahpasa Medical Faculty, Department of Otorhinolaryngology, Istanbul University, Istanbul 34098, Turkey.
⁶ CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands.
⁷ Department of Dermatology, Samatya Training and Research Hospital, Istanbul 34098, Turkey.

Abstract

Coccidioidomycosis caused by Coccidioides immitis or Coccidioides posadasii is endemic in arid climate zones in America, travel-related cases have been reported. We report the first documented case of coccidioidomycosis in Turkey, overviewing reported cases in Europe and underlying difficulties of differential diagnosis outside endemic regions. The patient was an otherwise healthy 41-year-old man who travelled endemic areas. Laboratory diagnosis was based on direct microscopy of two subsequent subcutaneous biopsy specimens and culture and confirmed molecularly. Laboratory personnel should become aware that BioSafety Level-3 organisms may become more frequent and widespread.

Keywords: Coccidioides; Coccidioidomycosis; Laboratory safety; Non-endemic countries.