The chest clinician familiar with tuberculosis will note some parallelism on the chest roentgenogram between that disease and coccidioidomycosis. Exudative tuberculosis resembles primary coccidioidal pneumonitis. In both diseases a primary pleuritic effusion may form. The miliary form of tuberculosis is remarkably like that seen in the lungs of a patient with chronic coccidioidal dissemination. Pulmonary cavitation occurs in both, as do fibrocaseocalcific lesions. Coccidioidal meningitis is very similar to tuberculous meningitis, including the cerebrospinal fluid changes. Psoas and paravertebral abscesses occur in both infections, as does a scrofulous-appearing suppurative cervical adenitis. It is not at all unusual to find that patients with coccidioidomycosis have been treated for tuberculosis in well-known sanatoria, sometimes for many months, and with unjustifiable economic loss to the patient. One is apt to assume that Coccidioides immitis is a frank imitator of Mycobacterium tuberculosis, but this apparent resemblance in the x-ray may perplex the clinician as
Winn WA. Coccidioidomycosis: The Need for Careful Evaluation of the Clinical Pattern and Anatomical Lesions. Arch Intern Med. 1960;106(4):463–466. doi:10.1001/archinte.1960.03820040001001
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