A Case of a Disseminated Coccidioidomycosis Presenting as Supraclavicular Mass

Abstract

Coccidioidomycosis, also known as Valley fever, is an infection caused by exposure to dimorphic soil-dwelling fungi of the genus Coccidioides. Inhalation of the arthroconidia from either fungi C. immitis or C. posadasii causes lung infections. Lung pathology is by far the most common presentation of coccidioidomycosis, representing over 95% percent of all cases. Disseminated coccidioidomycosis, a rare complication, presents as meningitis, osteomyelitis, or cutaneous lesions, results from the hematogenous spread of the organism. Though coccidioidomycosis dissemination is well known, it is rarely considered in the differential of a supraclavicular mass, where the diagnosis is malignancy until proven otherwise. Here we report a case of disseminated coccidioidomycosis in an immune-component individual presenting as supraclavicular mass.