Disseminated coccidioidomycosis in an immunocompetent person living in New York City.
Chuang A, Thomas R, Hoffman RS. J Urban Health. 2005 Jun;82(2):339-45. Epub 2005 May 12; Department of Emergency Medicine, Bellevue Hospital Center, New York

Coccidioidomycosis is a disease caused by Coccidioides immitis, a soil-inhabiting fungus endemic to the desert climate of the southwestern United States and Central and South America. We report a case of disseminated coccidioidomycosis in a previously healthy person living in New York City, who was initially thought to have tuberculosis. The incidence of coccidioidomycosis has been increasing in both endemic and nonendemic areas, but diagnosis is often delayed or missed in nonendemic areas, resulting in extensive and unnecessary medical workup for other diseases or progression to serious disease. Therefore, clinicians should increase their awareness and consideration of this disease in patients with chronic systemic illness.