Primary pulmonary coccidioidomycosis

Coccidioidomycosis is an infection caused by the soil-inhabiting fungus Coccidioides immitis. The fungus is endemic in the desert Southwest, which is a major area for tourism and growth. Travel through this region results in many new coccidioidal pulmonary infections annually, including pneumonia, cavities, and nodules. Patients with coccidioidomycosis are therefore likely to present with pulmonary manifestations of infection when they return home to nonendemic parts of the country. This makes coccidioidomycosis a fungal infection of nationwide importance, and it is crucial that physicians everywhere have a heightened awareness of this disease to avert delays in diagnosis and treatment. This article describes primary pulmonary coccidioidomycosis and its complications for clinicians practicing both in endemic and nonendemic areas.