CTICasesDisseminated Coccidioidomycosis
Imaging findings
Chest CT in a lymphoma patient post-chemotherapy demonstrates rapid development of diffuse, bilateral consolidative opacities and widespread miliary/centrilobular nodules. Bronchoalveolar lavage (BAL) fluid cultures speciated as Coccidioides, representing opportunistic dissemination. The patient showed significant resolution of the consolidations on follow-up CT after antifungal therapy.
Key takeaways
Coccidioidomycosis is a fungal infection endemic to the southwestern United States and parts of Central and South America. While usually self-limiting in immunocompetent hosts, immunosuppression (such as chemotherapy for lymphoma) predisposes to rapid pulmonary dissemination and miliary disease. BAL culture is diagnostic, and aggressive antifungal therapy is required.
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