Coccidioidomycosis

Caused by Coccidioides imitus, a soil fungus endemic to the Southwest (San Joaquin Valley)

• Primary coccidioidomycosis

     • Most are asymptomatic

     • Clinically, may have arthralgias, skin rash

Imaging

       • Patchy infiltrates mainly in lower lobes (80%)

        • Hilar adenopathy (20%)

        • Pleural effusion (10%)

• Disseminated coccidioidomycosis

       • Meningeal spread

       • Micronodular lung pattern

• Chronic coccidioidomycosis

       • One or more well-defined nodules (5%)

       • “Grape-skin“ thin-walled upper lobe cavities, mostly solitary

             • Resembles TB

      • Mediastinal adenopathy (10%)