<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0028-3746</journal-id>
<journal-title><![CDATA[Neumología y cirugía de tórax]]></journal-title>
<abbrev-journal-title><![CDATA[Neumol. cir. torax]]></abbrev-journal-title>
<issn>0028-3746</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Mexicana de Neumología y Cirugía de Tórax; Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas; Sociedad Cubana de Neumología; Sociedad Paraguaya de Neumología; Sociedad Boliviana de Neumología.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0028-37462023000400253</article-id>
<article-id pub-id-type="doi">10.35366/117942</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Delayed diagnosis of tuberculosis in a patient with coccidioidomycosis]]></article-title>
<article-title xml:lang="es"><![CDATA[Retraso en el diagnóstico de tuberculosis en un paciente con coccidioidomicosis]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rojas-Rojas]]></surname>
<given-names><![CDATA[Eva Alejandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cinencio-Chávez]]></surname>
<given-names><![CDATA[Wendy Rosario]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Laniado-Laborín]]></surname>
<given-names><![CDATA[Rafael]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Autónoma de Baja California  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,CONAHCYT Sistema Nacional de Investigadores ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2023</year>
</pub-date>
<volume>82</volume>
<numero>4</numero>
<fpage>253</fpage>
<lpage>255</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0028-37462023000400253&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0028-37462023000400253&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0028-37462023000400253&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: We present the case of a 24-year-old man from Sonora, residing in Tijuana, Mexico, who referred symptoms of cough and hemoptysis for a year. A chest CT scan showed fibrocavitary lesions, initially suspected to be tuberculosis. Rapid molecular tests did not detect Mycobacterium tuberculosis, while coccidioidomycosis serology was positive and cultures identified Coccidioides spp.; treatment with itraconazole was initiated, but subsequently, the mycobacterial culture was reported as positive for M. tuberculosis, confirming coinfection and antituberculosis treatment was added. The Xpert MTB/RIF test is recommended by the World Health Organization as an initial diagnostic method for tuberculosis due to its high sensitivity and specificity. However, its sensitivity can be low in cases of very low bacillary load, justifying the need for complementary mycobacterial cultures for a thorough diagnosis. In this case, the culture allowed for the detection of tuberculosis despite negative sputum smears and rapid molecular tests, highlighting the importance of phenotypic methods in the diagnosis of tuberculosis. The coinfection of tuberculosis and coccidioidomycosis is a significant diagnostic challenge. The combination of molecular tests and cultures remains essential for an accurate diagnosis and effective treatment, especially in endemic areas for both diseases.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: Presentamos el caso de un hombre sonorense de 24 años, residente en Tijuana, México, que presentó cuadro de tos y hemoptisis de un año de evolución. Una tomografía torácica mostró lesiones fibrocavitarias, inicialmente sugestivas de tuberculosis. Las pruebas moleculares rápidas no detectaron Mycobacterium tuberculosis, mientras que la serología para coccidioidomicosis fue positiva y los cultivos identificaron Coccidioides spp.; se inició tratamiento con itraconazol, pero posteriormente el cultivo micobacteriano se reportó positivo para M. tuberculosis, confirmándose la coinfección, por lo que se agregó tratamiento antituberculosis. El Xpert MTB/RIF está recomendado por la Organización Mundial de la Salud como método de diagnóstico inicial de tuberculosis debido a su alta sensibilidad y especificidad. Sin embargo, su sensibilidad puede ser baja en casos de baja carga bacilar, justificando la necesidad de cultivos micobacterianos complementarios para un diagnóstico exhaustivo. En este caso, el cultivo permitió la detección de tuberculosis a pesar de baciloscopias y prueba molecular rápida negativas, destacando la importancia de los métodos fenotípicos en el diagnóstico de tuberculosis. La coinfección de tuberculosis y coccidioidomicosis representa un importante desafío diagnóstico. La combinación de pruebas moleculares y cultivos es esencial para un diagnóstico preciso y un tratamiento eficaz, especialmente en zonas endémicas de ambos padecimientos.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[tuberculosis]]></kwd>
<kwd lng="en"><![CDATA[coccidioidomycosis]]></kwd>
<kwd lng="en"><![CDATA[coinfection]]></kwd>
<kwd lng="en"><![CDATA[Xpert MTB/RIF]]></kwd>
<kwd lng="en"><![CDATA[mycobacterial culture]]></kwd>
<kwd lng="es"><![CDATA[tuberculosis]]></kwd>
<kwd lng="es"><![CDATA[coccidioidomicosis]]></kwd>
<kwd lng="es"><![CDATA[coinfección]]></kwd>
<kwd lng="es"><![CDATA[Xpert MTB/RIF]]></kwd>
<kwd lng="es"><![CDATA[cultivo de micobacterias]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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