A 53-year-old man presents with a headache and general malaise. Diagnostic imaging identifies a mass in the brain.
Correct answer: C – Coccidioidomycosis
Coccidioidomycosis is a fungal infection caused by the fungus, Coccidioides. The organism is found in the southwestern part of the United States, Central America and South America. In rare cases, when the infection is in the central nervous system, the symptoms may be similar to those of a brain tumor. However, the infection is more common in the respiratory tract (lungs) due to the inhalation of fungal spores. Immunoglobulin M antibodies can be detected within 2 weeks after infection in about 75% of patients. In the brain, the infection may appear as a cavitary lesion. Final diagnosis is the identification of the large, round to oval spherules containing multiple endospores. These fungal organisms can be easily identified using a silver stain in tissue sections. Antifungal drugs are commonly used in the treatment of these fungal infections, including amphotericin B.
