Infection of the thyroid gland with Coccidioides is rare, with fewer than 50 cases reported since 1970. Disseminated infection complicates less than one percent of cases and occurs most often in immunocompromised patients. Since most patients are asymptomatic, they may experience a delay in diagnosis and treatment. aspiration thyroid biopsy proved helpful in establishing the diagnosis of coccidioidomycosis. The ideal management is unclear, but some studies suggest three years of oral azoles after disseminated coccidioidomycosis to other soft tissue organs.
We report a case of disseminated coccidioidomycosis involving the thyroid gland, a sporadic infection. The overall mortality is high due to delayed diagnosis and treatment. The diagnosis is determined by the culture of a - aspirate or/and a biopsy followed by direct microscopy. However, the optimal treatment, duration, and medication dosage remain controversial.