Extract
Coccidioides immitis is endemic in arid parts of the southwestern
United States and regions of Central and South America. Symptomatic infection
(comprising 40% of cases) initially presents as a flu-like illness with fever,
cough, headache, rash, and myalgias. Some patients (especially those who are
immunocompromised) fail to recover, with the development of chronic pulmonary
infection or widespread disseminated
infection1.A Coccidioides immitis infection that is disseminated to bone is
very difficult to treat and usually requires lifetime suppressive antifungal
therapy1-3.
The present report describes a patient with recurrent osseous coccidioidal
osteomyelitis at a new locus who presented after minor trauma to the middle
part of the foot. The patient was managed successfully with surgical
débridement and antifungal medication. The pathophysiology of osseous
infection and treatment options are discussed. The patient was informed that
data concerning this case would be submitted for publication.