CTICasesDisseminated Coccidioidomycosis
Imaging findings
A liver transplant recipient presented with weight loss, malaise, and fever, initially treated for pneumonia. Subsequent chest CT revealed a miliary nodular pattern throughout the lungs in addition to focal consolidation. An umbilical skin lesion was identified and biopsied.
Key takeaways
Disseminated fungal infections, such as Coccidioidomycosis, can present with both miliary pulmonary patterns and focal consolidation. In immunocompromised patients or those from endemic areas (e.g., Central Valley), vigilance for extrapulmonary manifestations, such as skin lesions (e.g., umbilical nodules), is crucial for early diagnosis, potentially avoiding more invasive pulmonary biopsies.
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