Bone Scan, PET-CT, and MRI in Disseminated Coccidioidomycosis

Abstract

Coccidioidomycosis (valley fever) is a systemic fungal infection resulting from inhalation of the Coccidioides immitis or posadasii spores. In many cases, infection causes a self-limited community-acquired pneumonia; however, in patients with risk factors, such as immunosuppression or African or Pacific Island ancestry, significant morbidity and mortality from disseminated disease may occur. Presented here are comparative images using Tc-MDP bone scan, F-FDG PET/CT, and MRI. Each demonstrates particular strengths, which aid in assessing the extent of systemic involvement of a biopsy-proven case of disseminated coccidioidomycosis.

Unexpected coccidioidomycosis presenting as lung nodules with presumptive diagnosis of malignancy

“…An FDG PET scan is commonly used to detect metabolically active malignant lesions and may be used to more accurately stage malignant diseases and to monitor the therapy response of malignant diseases. However, although it is especially helpful in detecting metastatic malignancy, FDG‐positive lesions can also be seen in nonmalignant conditions including infections such as coccidioidomycosis, 4 inflammations, autoimmune disorders, sarcoidosis, and benign tumors. 5 If these conditions are not identified clinically and/or by tissue biopsies, misdiagnosis can lead to inappropriate therapies.…”