Three weeks after traveling to California to study desert flowers, a 32-year-old man develops a fever, chest pain, and sore muscles. Two days later, red tender nodules appear on the shins, and the right ankle is painful and tender. An x-ray of the chest shows a left pleural effusion. Which of the following is the most likely diagnosis?
(D) Mycobacterium marinum infection
(E) Mycoplasma pneumoniae infection
Correct answer : (B) Coccidioidomycosis
Coccidioidomycosis – also known as “California disease”, “Desert rheumatism”, “San Joaquin valley fever” and “Valley fever” is a fungal disease caused by Coccidioides immitis or C. posadasii. The disease is usually mild, with flu-like symptoms and rashes. Serious complications include severe pneumonia, lung nodules, and disseminated disease, where the fungus spreads throughout the body. The disseminated form of valley fever can devastate the body, causing skin ulcers, abscesses, bone lesions, severe joint pain, heart inflammation, urinary tract problems, meningitis, and often death.