CTICasesProgressive Coccidioidomycosis Cavity
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Imaging findings
A patient with known coccidioidomycosis had a small cavity in the left upper lobe in 2011. Over three years, it progressively enlarged, initially with a smooth wall, then becoming thicker, more irregular, and inflammatory, possibly communicating with the airway. By 2015 and 2016, the cavity continued to grow, showing some fluid and calcium along its wall.
Key takeaways
While coccidioidomycosis cavities typically resolve in about 85% of patients, this case demonstrates a chronic, progressive course over four years that did not regress, eventually requiring surgical resection. Hesitation to operate on coccidioidomycosis lesions exists due to the risk of contaminating the pleural space and spreading the infection. Additionally, strict precautions are necessary when handling specimens to prevent laboratory personnel from contracting the disease.
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