Disseminated coccidioidomycosis discovered during routine skin cancer screening.
A 78-year-old white man presented for routine dermatologic examination. A 4x4-mm erythematous papule was noted on the left upper back. It was asymptomatic and previously unnoticed by the patient. The results of a shave biopsy revealed a large spherule with granular cytoplasm diagnostic of coccidioidomycosis. Chest x-ray revealed a 1.8-cm right upper lobe mass. The complement fixation antibody titer for cocci was 1:128. The patient was treated for disseminated coccidioidomycosis with oral fluconazole. The epidemiology, diagnosis, and management of coccidioidomycosis are discussed.
San Antonio Uniformed Services Health Education Consortium, Texas, USA. btlrance@msn.com
Braden R
BR
Rance
Dirk M
DM
Elston
D000368:Aged; D003047:Coccidioidomycosis / Q000175:diagnosis* / Q000473:pathology; D003881:Dermatomycoses / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis*; D008297:Male; D012878:Skin Neoplasms / Q000175:diagnosis*