Adjunctive corticosteroids therapy in acute respiratory distress syndrome owing to disseminated coccidioidomycosis

Coccidioides immitis causes a benign upper respiratory tract infection in endemic areas. Acute respiratory distress syndrome is a rare complication that is associated with high mortality. Corticosteroids have been avoided as adjunctive therapy to antifungals in the treatment of acute respiratory distress syndrome secondary to coccidioidomycosis because of the fear of enhancing fungal virulence, but they have been proven safe and effective in other infectious entities. We are presenting a case of severe acute respiratory distress syndrome owing to a fulminant coccidioidomycosis infection that responded to a short course of systemic corticosteroids in addition to the standard antifungal treatment.