Coccidioidomycosis physical examination
Coccidioidomycosis physical examination On the Web
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. ; Associate Editor(s)-in-Chief: ; Vidit Bhargava, M.B.B.S ; Aditya Ganti M.B.B.S. 
The physical manifestations of the disease depends on the organ of involvement. In the order of incidence the most commonly involved organs are lungs, skin, bones, genitourinary system, central nervous system and other organs.
Photophobia, episcleritis, conjunctivitis, scleritis
- In cases with skin involvement from direct inoculation, regional lymph node enlargement may be seen.
- No masses
- Regular rate and rhythm
- Normal S1, S2
- No murmurs, rubs, or gallops
Findings consistent with parenchymal consolidation such as
- Dullness to percussion
- Increased fremitus
- Bronchial breathing.
- Rales & Ronchi
- Abdomen soft and non-distended with no scars or striations
- No pulsatile masses or abdominal bruits auscultated
- Spleen not palpable, liver not palpable
- Erythema nodosum ( It presents as tender red nodules on the shins that are smooth and shiny)
- Erythema multiforme( classical "target lesion" appearance, with a pink-red ring around a pale center)
- Verrucous lesions with irregular border and variegated appearance
Bone and joints
- Soft tissue swelling around the area of involvement and discharging sinuses might be consistent with osteomyelitis.
- Arthritis can cause reproducible pain in joints.
- Ulcers that bleed on touch
Normal examination findings are seen unless the infection is disseminated to the brain resulting in meningitis, findings of neural involvement include:
- Altered level of consciousness
- Nuchal rigidity
- Increased intracranial pressure is a most common finding when meninges are involved.
Erythema nodosum lesions on skin of back due to hypersensitivity to antigens of Coccidioides immitis. From Public Health Image Library (PHIL). 
Chronic lesion that had been determined to be due to a Coccidioides sp. fungal infection. From Public Health Image Library (PHIL). 
Large red spot formed at volar surface of patient's left arm, indicating a positive result to a skin test to determine whether patient was exposed to the Coccidioides spp. fungal organism. From Public Health Image Library (PHIL). 
- ↑ Stockamp NW, Thompson GR (2016). "Coccidioidomycosis". Infect. Dis. Clin. North Am. 30 (1): 229–46. doi:10.1016/j.idc.2015.10.008. PMID 26739609.
- ↑ Twarog M, Thompson GR (2015). "Coccidioidomycosis: Recent Updates". Semin Respir Crit Care Med. 36 (5): 746–55. doi:10.1055/s-0035-1562900. PMID 26398540.
- ↑ DiCaudo DJ (2014). "Coccidioidomycosis". Semin Cutan Med Surg. 33 (3): 140–5. PMID 25577855.
- ↑ Malo J, Luraschi-Monjagatta C, Wolk DM, Thompson R, Hage CA, Knox KS (2014). "Update on the diagnosis of pulmonary coccidioidomycosis". Ann Am Thorac Soc. 11 (2): 243–53. doi:10.1513/AnnalsATS.201308-286FR. PMID 24575994.
- ↑ Kauffman, Carol (2011). Essentials of clinical mycology. New York: Springer. ISBN 978-1-4419-6639-1.
- ↑ 6.0 6.1 6.2 "Public Health Image Library (PHIL)".