title: Disseminated coccidioidomycosis with multifocal musculoskeletal disease involvement.
abstract: We report a rare case of disseminated coccidioidomycosis with multifocal musculoskeletal involvement. The patient presented to the emergency department with left shoulder pain and swelling. Magnetic resonance imaging of the left shoulder revealed enhancing soft tissue masses, bony lesions, and fluid collections in and around the glenohumeral joint with involvement of the proximal humerus, glenoid, and rotator cuff musculature. Multiple additional areas of involvement were subsequently discovered. Fungal cultures confirmed coccidioidomycosis infection at all surgical sites with superimposed polymicrobial bacterial infection in the left shoulder.
authors.affiliation: Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Unit 1476, 1515 Holcombe Blvd, Houston, TX 77030, USA.
authors.forename: Michael F
authors.initials: MF
authors.lastname: McConnell
authors.affiliation: Department of Radiology, CHI St. Luke's Health-Baylor St. Luke's Medical Center, Houston, TX, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Shi
authors.affiliation: Department of Clinical Microbiology, CHI St. Luke's Health-Baylor St. Luke's Medical Center, Houston, TX, USA; Department of Molecular Pathology, CHI St. Luke's Health-Baylor St. Luke's Medical Center, Houston, TX, USA.
authors.forename: Todd M
authors.initials: TM
authors.lastname: Lasco
authors.affiliation: Department of Radiology, CHI St. Luke's Health-Baylor St. Luke's Medical Center, Houston, TX, USA.
authors.forename: Luke
authors.initials: L
authors.lastname: Yoon
keywords: Coccidioides immitis; Coccidioidomycosis; Disseminated