Coccidioidomycosis

A 51-year-old Filipino male physician residing in Arizona developed disseminated coddidioidomycosis. After admission to the National Institutes of Health, he was noted to have many focal areas of active chorioretinitis in both eyes. The organism was cultured from the sputum, cerebrospinal fluid, and urine. The patient received amphotericin B by intravenous, intrathecal, and intraventricular routes. With this therapy the disseminated disease cleared and the chorioretinal lesions healed with a "punched-out" appearance and with varying degrees of hyperpigmentation at the borders.