CTICasesDisseminated Coccidioidomycosis
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Imaging findings
Chest CT demonstrated necrotic lymph nodes in the supraclavicular, lower cervical, and mediastinal regions, along with a large, symptomatic pericardial effusion (with tamponade). Small pulmonary nodules and compressive atelectasis were also present.
Key takeaways
This case illustrates disseminated Coccidioidomycosis presenting with pericardial effusion and extensive necrotic lymphadenopathy. Such a presentation can mimic tuberculosis or other severe infections/malignancies. Diagnosis was confirmed by growing Coccidioides from lymph nodes, pericardial fluid, and sputum. The geographic context (patient from Thailand, though Coccidioidomycosis is endemic to the Americas) is a key factor in considering this diagnosis.
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