particularly occurs in diabetics and patients with a compromised immune system.
features include the development of cavitating lesions and empyema.
common sites of disseminated disease are the bones of the skull, spine, hands, feet and tibia. Generally joint involvement is unifocal and the most commonly involved joints are the ankle and knee.
meningitis - may only involve the basilar meninges.
Reference
Galgiani JN, Ampel NM, Blair JE, et al. 2016 Infectious Diseases Society of America (IDSA) clinical practice guideline for the treatment of coccidioidomycosis. Clin Infect Dis. 2016 Sep 15;63(6):e112-46.
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