Watermark image Pathology Image
Edge of necrotizing lesion
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CASE BACKGROUND
52 year old with a 2 cm cavitary right upper lobe nodule.
COCCIDIOMYCOSIS
C. immitis has an ecologic niche requiring low elevation, scant rainfall, mild winters and hot summers, and sandy alkaline soil, which restricts its areas in this hemisphere to southern-central California (San Joaquin Valley), Arizona, southern New Mexico, western Texas, and northern Mexico.

Disturbance of the soil allows for dissemination of the arthroconidia which if inhaled by a susceptible host, produce infection. The arthrospore sheds its outer coating, swells, and becomes a round structure called a spherule. When the spherule ruptures, the endospores are released, each of which matures into spherules, repeating the cycle.
RELATED CASES/FURTHER READING
Lung : Coccidioidomycosis
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