CTICasesRefractory locally aggressive coccidioidomycosis
Imaging findings
Serial CT scans show a thick-walled left lower lobe cavitary nodule that progressively enlarges over several months and crosses the major fissure into the upper lobe, correlating with rising serum coccidioidomycosis titers.
Key takeaways
Coccidioidomycosis can be locally aggressive, crossing anatomical barriers like the pleural fissures. Rising titers indicate active, uncontrolled disease, which may require long-term, high-dose antifungal therapy or surgical intervention.
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