Abstract
Disseminated coccidioidomycosis is a disease caused by Coccidioides species, fungi endemic to the southwestern United States. We present here an uncommon case of a young child with erythema nodosum and fever of unknown origin, found to have the infection. While more common in adults, coccidioidomycosis should be considered in all patients with erythema nodosum.
Highlights
Coccidioidomycosis, known as “San Joaquin fever” or “Valley fever,” is an infection caused by Coccidioides species, dimorphic fungi typically found in the soil [1]. e fungi are endemic to the southwestern United States [1]
Rheumatologic workup consisted of additional laboratory testing including complement levels and an echocardiogram
A diagnosis of disseminated coccidioidomycosis was made, and the patient was started on fluconazole, with a plan to treat for 12 months
Summary
Coccidioidomycosis, known as “San Joaquin fever” or “Valley fever,” is an infection caused by Coccidioides species, dimorphic fungi typically found in the soil [1]. e fungi are endemic to the southwestern United States [1]. Coccidioidomycosis, known as “San Joaquin fever” or “Valley fever,” is an infection caused by Coccidioides species, dimorphic fungi typically found in the soil [1]. Disseminated disease is much more common in adults than children and typically occurs several weeks to months after the initial infection [4]. Coccidioides infection has been shown to be on the differential for fever of unknown origin. Using the revised Durack definition of fever of unknown origin defined as temperature greater than 38.3 C, duration of greater than 3 weeks, and evaluation of at least 3 outpatient visits or 3 days in hospital, our patient was found to meet criteria [5]. Our patient can be categorized into the classic fever of unknown origin category as fevers occurred secondary to infection [5]. We present a rare case of a young child presenting with erythema nodosum and fever of unknown origin, found to have disseminated coccidioidomycosis
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