Disseminated coccidioidomycosis masquerading as recurrent lymphoma

Infection with Coccidioides immitis , a soil-dwelling fungus endemic to the American Southwest, may have protean manifestations in immunocompromised patients who reside in1 2 or who have travelled to3 that region. We report a patient whose abnormal PET/CT scan raised concern for recurrent lymphoma but instead was due to disseminated coccidioidomycosis. A 62-year-old woman was diagnosed with ileocaecal marginal zone lymphoma (MZL) after presenting with iron-deficiency anaemia and faecal occult blood. Ten years earlier, she underwent allogeneic haematopoietic cell transplantation for acute myeloid leukaemia (AML). She had recurrent cutaneous chronic graft-versus-host-disease (CGVHD); 50 months before the diagnosis of MZL, she completed a 9-month course of …