Coccidioidomycosis masquerading as malignancy. (28th February 2012)

• Record Type: Journal Article
• Authors: Arora, Natasha Purai; Taneja, Vikas; ReyesSacin, Carlos; Bhanot, Ravinder; Natesan, Suganthini Krishnan
• Is Part Of: BMJ case reports. Volume 2012
• Publication Date: 2012-02-28
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr.12.2011.5357
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : 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.