Persistent adenopathy in coccidioidomycosis: an indication for therapy

Area of Science:

• Medical Mycology
• Infectious Diseases
• Radiology

Background:

• Coccidioidomycosis is a fungal infection endemic to certain regions.
• Differential diagnosis of persistent pulmonary findings can be challenging.
• Lymphoma is a significant consideration in cases of persistent adenopathy.

Observation:

• Three patients presented with persistent adenopathy on chest roentgenograms.
• Initial pulmonary infiltrates resolved, but lymph node enlargement remained.
• This radiographic pattern mimicked findings typical of lymphoma.

Findings:

• Persistent adenopathy after resolution of initial infiltrate suggests disseminated coccidioidomycosis.
• The clinical presentation can be mistaken for lymphoproliferative disorders.
• Radiographic persistence of adenopathy is a key indicator.

Implications:

• Early recognition of this pattern is crucial for timely diagnosis.
• Prompt initiation of antifungal therapy is recommended when dissemination is suspected.
• This highlights the importance of considering fungal infections in the differential diagnosis of persistent adenopathy.