Right lung cavitation: Don't forget coccidioidomycosis - A case report

A 65-year-old female patient developed recurrent cough and sputum production without an apparent cause for 4 months prior. A chest CT scan performed 1 month earlier revealed a right lower lung opacity with cavitation. Despite treatment, she continued to experience paroxysmal coughing. Upon admission, multiple investigations were conducted, including chest CT, T-cell testing for tuberculosis infection, bronchoscopy, lung biopsy, and next-generation sequencing. The final diagnosis was pulmonary coccidioidomycosis presenting as right lower lung opacity with cavitation. Improvement was observed following treatment with fluconazole tablets. For pulmonary cavitation, beyond common causes such as lung cancer and tuberculosis, rare aetiologies, including coccidioidomycosis, must be considered, particularly in patients with relevant travel history to endemic regions. This case provides valuable diagnostic insights and therapeutic reference.