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Image Number 355 (Coccidioidomycosis)

 
Morphology:
Abscess

Diagnosis: Coccidioidomycosis

Site: Chest

Sex: M

Age: 28

Type: Clinical

Description: Large indolent abscess

Submitted by: Ian McColl

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Differential Diagnosis

History: Disseminated Coccidiodomycosis is a very rare disease.The organism Coccidiodes immitis is inhaled and settles in the lungs causing small abscesses and associated hypersensitivity reactions such as erythema nodosum.However if dissemination occurs any organ can be affected.Skin involvement gives indolent abscesses as shown in the first case on the chest and face, that may eventually rupture and form granulomatous ulcers such as the one shown in another case on the nasolabial fold,a very typical site.Dissemination is commoner in immunosupressed patients.The treatment of choice is fluconazole 400 to 800 mgs daily orally.

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