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Disseminated coccidioidomycosis in a renal transplant recipient

Imaging findings

CT scan shows innumerable small, randomly distributed miliary nodules, small pleural effusions, and multiple fluid collections/abscesses within the right sternocleidomastoid and infraspinatus muscles. Brain CT and MRI demonstrate a right temporal lobe abscess.

Key takeaways

Immunosuppressed patients are highly susceptible to disseminated coccidioidomycosis. The combination of random/miliary lung nodules, brain abscesses, and deep intramuscular or subcutaneous abscesses is highly suggestive of disseminated fungal infection.

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