[First report of coccidioidomycosis associated with Sweet syndrome].

BACKGROUND: We describe the first reported case associating coccidioidomycosis and Sweet syndrome, two uncommon diseases in Europe.

CASE REPORT: One month after traveling to Mexico, a 47-year-old woman developed a maculo-papulous rash on her trunk, neck and limbs. She also had cough, associated with signs of an upper respiratory tract infection and weight loss. Sweetís syndrome was first diagnosis and confirmed histologically on a skin lesion biopsy. An aspectific pulmonary infiltrate, associated with a left-sided paracardiac opacity was found on chest X-rays and the CT scan. Bronchoalveolar lavage products contained more than 60% lymphocytes. Serology using coccidioidin showed an F-precipitin on agar (IgM) and an IgG-titre of 1:8, leading to the diagnosis of primary Coccidioides immitis infection with a probable lung localization.

DISCUSSION: Search for an associated disease should be made in patients with Sweet syndrome. The Sweet syndrome coccidioidomycosis association could be related to TH-1 lymphocyte proliferation.