Coccidioidomycosis

Primary coccidioidomycosis is asymptomatic in up to three-quarters of patients. There may be arthralgia, or skin lesions such as erythema nodosum or erythema multiforme. Radiography of the chest shows alveolar opacification, with lymph node enlargement, and occasionally pleural effusion. The opacification clears after several weeks. Pulmonary nodules may appear later, 530 mm in size, which may calcify. Calcification of the lymph nodes is also recognized. Well-defined cavities have also been seen, which fibrose and may ultimately calcify.

Differentiation from tuberculosis can only be made by skin testing or identification of the organism in sputum or gastric washings.

MMc