Coccidioidomycosis masquerading as malignancy
- Natasha Purai Arora1,
- Vikas Taneja1,
- Carlos ReyesSacin2,
- Ravinder Bhanot1,
- Suganthini Krishnan Natesan2
- 1Department of Internal Medicine, Wayne State University School of Medicine, Detroit Medical Center, Detroit, Michigan, USA
- 2Department of Internal Medicine, Division of Infectious Diseases, Wayne State University School of Medicine, Detroit Medical Center, Detroit, Michigan, USA
- Correspondence to Dr Natasha Purai Arora,
Skeletal coccidioidomycosis is extremely rare and in the non-endemic areas, diagnosis is often delayed or missed resulting in extensive and unnecessary medical investigation for other diseases. The authors report a case of disseminated skeletal coccidioidomycosis in a previously healthy person living in a non-endemic area, who was initially thought to have a malignancy. Due to the presence of multiple expansile lytic bone lesions on x-rays and CT scan, an extensive investigation for malignancy was done. Diagnosis of coccidioidomycosis was made when H&E and Gomori’s methenamine silver staining of a bone biopsy sample revealed multiple fungal spherules, which were confirmed to be Coccidioides immitis by culture and PCR. On questioning, the patient admitted to have spent 2 weeks in Arizona (an endemic area) few months ago. He was discharged home on long-term fluconazole. At 1 month clinical follow-up, a significant improvement in his lesions was noticed.
Competing interests None.
Patient consent Obtained.