A Case of a Disseminated Coccidioidomycosis Presenting as Supraclavicular Mass

Coccidioidomycosis, also known as Valley fever, is an infectioncaused by exposure to dimorphic soil-dwelling fungi of the genusCoccidioides. Inhalation of the arthroconidia from either fungi C.immitis or C. posadasii causes lung infections. Lung pathology isby far the most common presentation of coccidioidomycosis,representing over 95% percent of all cases. Disseminatedcoccidioidomycosis, a rare complication, presents as meningitis,osteomyelitis, or cutaneous lesions, results from the hematogenousspread of the organism. Though coccidioidomycosis disseminationis well known, it is rarely considered in the differential of asupraclavicular mass, where the diagnosis is malignancy untilproven otherwise. Here we report a case of disseminatedcoccidioidomycosis in an immune-component individualpresenting as supraclavicular mass.