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Case Report
A multifaceted presentation of disseminated coccidioidomycosis: A case review
1 High School Student, Vista Del Lago High School, 1970 Broadstone Pkwy, Folsom, CA 95630, USA
2 Associate Professor, Department of Radiology, UC Davis Medical Center, 4860 Y Street #3100, Sacramento, CA 95817, USA
3 Assistant Professor, Department of Pathology, UC Davis Medical Center, 4400 V Street, Sacramento, CA 95817, USA
Address correspondence to:
Priti Soin
MD, Assistant Professor, Department of Pathology, UC Davis Medical Center, 4400 V Street, Sacramento, CA 95817,
USA
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Article ID: 100097Z11SK2026
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Kochar S, Ghasemiesfe A, Soin P. A multifaceted presentation of disseminated coccidioidomycosis: A case review. J Case Rep Images Pathol 2026;12(1):1–5.ABSTRACT
Introduction: Coccidioidomycosis, commonly known as Valley fever, is an infectious disease caused by two highly virulent fungi, Coccidioides immitis and C. posadasii. Around 60% of the infections are asymptomatic, however one-third of the cases develop pulmonary infection. About 0.5–2% of the cases disseminate to extrapulmonary locations which can be skin, bones/joints, and central nervous system, frequently seen in immunocompromised individuals (e.g., transplant recipients, HIV patients, pregnancy, diabetics, and patients on steroids).
Case Report: We report a case of coccidioidomycosis in a 33-year-old diabetic male who presented with extrapulmonary manifestations involving thigh and facial skin followed by right chest wall complex collection which disseminated further to rib bone. The patient was found to be non-compliant on his antifungal drug regime which ultimately led to dissemination of the infection in the setting of preexisting diabetes. Following a surgical debridement procedure of the chest wall lesion and rib excision in addition with compliant antifungal regime led to eradication of the infection.
Conclusion: The diagnosis of coccidioidomycosis relies upon clinical suspicion, laboratory findings (serology, cultures, and histopathology) coupled with imaging findings. The key to eradicating infection is ultimately based on an appropriate course of antifungal antibiotics and patient compliance following an accurate and timely recognition of the infection.
Keywords: Coccidioidomycosis, Extrapulmonary, Virulent fungi
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Author Contributions
Sidak Kochar - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Ahmadreza Ghasemiesfe - Conception of the work, Design of the work, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Priti Soin - Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementNone
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2026 Sidak Kochar et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
