Coccidioidomycosis: an emerging disease in Taiwan

Coccidioidomycosis is an endemic fungal disease occurring almost exclusively on the American continent. Until 2021, only sporadic imported cases were observed in Taiwan. However, a dramatic surge in the number of cases over the past 3 years has been observed. Hence, we conducted a retrospective case series study between January 1, 2000, and May 31, 2025, at the National Taiwan University Hospital. Thirteen patients were included in the study. Most were workers or businessmen related to the Taiwan semiconductor factory expansion in Arizona, United States of America since 2020. All patients were surgically diagnosed in the chronic or latent phase using video-assisted thoracic surgery. Given the recent dramatic surge in imported cases of coccidioidomycosis, probably linked to the rapid expansion of Taiwan's semiconductor industry in the United States, we addressed the importance of obtaining travel and occupational histories and an urgent need of rapid diagnostic testing for coccidioidomycosis among healthcare providers in Taiwan.