LearningRadiology - Coccidioidomycosis

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

• X-ray

• 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%)

WH/‘93