Disseminated Coccidioidomycosis

A 60-year-old man with hypertension presented with hemoptysis and painful cervical masses. Imaging revealed enhancing supraclavicular fluid collections and a cavitary pulmonary lesion. Histopathology confirmed abscess formation with fungal spherules containing endospores, indicative of Coccidioides infection. Serologic and PCR testing identified Coccidioides immitis, leading to a diagnosis of disseminated coccidioidomycosis. The patient, who had not traveled outside Houston in 15 years, began extended oral fluconazole therapy, resulting in clinical improvement at 2-month follow-up.

A 60-year-old man with hypertension presented with hemoptysis and painful cervical masses. Imaging revealed enhancing supraclavicular fluid collections and a cavitary pulmonary lesion. Histopathology confirmed abscess formation with fungal spherules containing endospores, indicative of Coccidioides infection. Serologic and PCR testing identified Coccidioides immitis, leading to a diagnosis of disseminated coccidioidomycosis. The patient, who had not traveled outside Houston in 15 years, began extended oral fluconazole therapy, resulting in clinical improvement at 2-month follow-up.