# Dual Burden: Osteomyelitis Secondary to Disseminated Coccidioidomycosis in an Immunocompetent Patient

## TL;DR

A healthy adult developed a rare fungal infection that spread to the bones, requiring long-term antifungal treatment.

## Contribution

This case highlights disseminated coccidioidomycosis with osteomyelitis in an immunocompetent individual, a rare clinical scenario.

## Key findings

- Disseminated coccidioidomycosis can affect bones even in immunocompetent patients.
- Prolonged antifungal therapy and multidisciplinary care were necessary for management.
- Imaging and microbiologic studies confirmed osseous involvement of Coccidioides infection.

## Abstract

Disseminated coccidioidomycosis is a rare but serious complication of infection with Coccidioides species that can affect multiple organ systems, including bone. We report the case of an immunocompetent adult who developed disseminated coccidioidomycosis complicated by osteomyelitis. The patient initially presented with back pain and foot findings suggestive of infection. Diagnostic workup, including imaging and microbiologic studies, confirmed Coccidioides infection with osseous involvement. The patient was managed with prolonged antifungal therapy and multidisciplinary care.