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Coccidioidomycosis, caused by Coccidioides fungi, presents diverse symptoms from lung issues to widespread organ infections. Early CT scans help identify pulmonary Coccidioidomycosis, a common initial manifestation.

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Area of Science:

  • Mycology
  • Infectious Diseases
  • Radiology

Background:

  • Coccidioidomycosis is caused by dimorphic fungi, Coccidioides immitis and Coccidioides posadasii.
  • It is endemic to the southwestern US, presenting varied clinical and imaging findings.
  • Infection occurs via inhalation of arthroconidia from soil, leading to pulmonary disease.

Purpose of the Study:

  • To describe the diverse clinical and imaging manifestations of Coccidioidomycosis.
  • To highlight the propensity for pulmonary infections and extrapulmonary dissemination patterns.
  • To detail the CT features of pulmonary involvement and common sites of dissemination.

Main Methods:

  • Review of clinical and imaging findings in Coccidioidomycosis patients.
  • Analysis of computed tomography (CT) features of pulmonary Coccidioidomycosis.
  • Correlation of dissemination patterns with organ system involvement.

Main Results:

  • Pulmonary involvement is the most common manifestation, with CT showing nodules, consolidation, adenopathy, and effusions.
  • Extrapulmonary dissemination occurs in 1-5% of patients, frequently affecting the musculoskeletal and nervous systems.
  • Musculoskeletal involvement includes discitis-osteomyelitis and septic arthritis; neurologic complications include meningitis and cerebritis.

Conclusions:

  • Coccidioidomycosis exhibits a wide spectrum of disease, from localized pulmonary infections to disseminated multiorgan disease.
  • Radiographic findings, particularly CT, are crucial for diagnosing pulmonary Coccidioidomycosis and assessing dissemination.
  • Prompt recognition and management are essential due to potential severe morbidity and mortality from disseminated disease.