Coccidioidomycosis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Vidit Bhargava, M.B.B.S [2]

Physical Findings

There are no pathognomic signs for Coccidioidomycosis, however numerous findings are observed depending on the organ system involved. Features suggestive of disseminated disease include :- profuse sweating, dyspnea, high grade fever and weight loss. Specific findings :-

Respiratory system

• Bronchial breathing.
• Rales & Ronchi
• Areas of consolidation with resultant dullness to percussion , and increased tactile and vocal fremitus.
• 5-10% cases may develop pulmonary nodules which may resolve spontaneously or may ulcerate and cause hemoptysis.

Skin manifestations

Erythema nodosum presenting as tender, erythematous nodules, about 1-2 cm in size are classic in endemic areas. Ocular hypersensitivity is a frequent finding presenting as episcleritis,conjunctivitis, sclerities. Cutaneous hypersensitivity sometimes occur and needs to be differentiated from cutaneous involvement which is a bad prognostic sign. classical skin manifestation of coccidioidomycosis is a verrucous granuloma at the nasolabial fold.