Resistant Pneumonia
Case Shakes Up
Diagnostic Rules
Wolfgang Paik
June 11, 2025
Key Takeaways
A 61-year-old man presented with fever,
dyspnoea, cough, and maculopapular rash.
The patient had no relevant medical history.
Laboratory tests revealed leucocytosis.
A chest x-ray showed an infiltrate in the
right lower lobe of the lung, which was
confirmed by CT. However, antibiotics did
not improve the condition.
This rare case report by Ahmad B. Al-
Zughoul, MD, a resident doctor of internal
medicine, Saint Agnes Medical Center,
Fresno, California, describes simultaneous
bacterial (Mycoplasma pneumoniae), viral
(coronavirus NL63), and fungal
(Coccidioides spp.) pneumonia in an
immunocompetent adult.
The Patient and His History
The patient with no past medical history
presented to the emergency department
with a week-long history of skin rash, fever,
and shortness of breath. The patient denied
any preexisting medical conditions.
1/4
Case Shakes Up
Diagnostic Rules
Wolfgang Paik
June 11, 2025
Key Takeaways
A 61-year-old man presented with fever,
dyspnoea, cough, and maculopapular rash.
The patient had no relevant medical history.
Laboratory tests revealed leucocytosis.
A chest x-ray showed an infiltrate in the
right lower lobe of the lung, which was
confirmed by CT. However, antibiotics did
not improve the condition.
This rare case report by Ahmad B. Al-
Zughoul, MD, a resident doctor of internal
medicine, Saint Agnes Medical Center,
Fresno, California, describes simultaneous
bacterial (Mycoplasma pneumoniae), viral
(coronavirus NL63), and fungal
(Coccidioides spp.) pneumonia in an
immunocompetent adult.
The Patient and His History
The patient with no past medical history
presented to the emergency department
with a week-long history of skin rash, fever,
and shortness of breath. The patient denied
any preexisting medical conditions.
1/4
