Fatal cokeromyces recurvatus pneumonia: Report of a case highlighting the potential for histopathologic misdiagnosis as coccidioides

Lori J. Ryan, Patricia Ferrieri, Ralph D. Powell, Christopher D. Paddock, Sherif R. Zaki, Stefan E. Pambuccian

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Cokeromyces recurvatus is a dimorphic zygomycete with histologic morphology similar to Coccidioides immitis. A 66-year-old man who was status-post bone marrow transplantation for chronic myelogenous leukemia was hospitalized with new onset rash, nausea, and vomiting and subsequently expired. A sputum culture collected on the day of death revealed heavy growth of C. recurvatus 6 days after collection. At autopsy, microscopic examination of the lungs revealed numerous thick-walled, nonbudding spherules ranging in size from 40 to 80 μm. Initial immunohistochemical staining of the formalin-fixed lung tissue was positive for Coccidioides. Additional immunoperoxidase staining revealed the organisms were consistent with a zygomycete fungus, compatible with C. recurvatus infection. Polymerase chain reaction using panfungal primers was attempted on the formalin-fixed tissue but was inconclusive. This case highlights the potential for misdiagnosing Cokeromyces as Coccidioides when the diagnosis is based on histology and immunohistochemical staining.

Original languageEnglish (US)
Pages (from-to)373-376
Number of pages4
JournalInternational Journal of Surgical Pathology
Volume19
Issue number3
DOIs
StatePublished - Jun 2011

Bibliographical note

Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.

Keywords

  • Coccidioides immitis
  • Cokeromyces recurvatus pneumonia

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