Bone scan, PET-CT, and MRI in disseminated Coccidioidomycosis

Coccidioidomycosis (valley fever) is a systemic fungal infection resulting from inhalation of the Coccidioides immitis or posadasii spores. In many cases, infection causes a self-limited community-acquired pneumonia; however, in patients with risk factors, such as immunosuppression or African or Pacific Island ancestry, significantmorbidity and mortality from disseminated disease may occur. Presented here are comparative images using ^99mTc-MDP bone scan, ¹⁸F-FDG PET/CT, and MRI. Each demonstrates particular strengths, which aid in assessing the extent of systemic involvement of a biopsy-proven case of disseminated coccidioidomycosis.