A Case of Systemic Fungal Infection Diagnosed After Tongue Mass Biopsy

Introduction: Coccidioidomycosis is a fungal infection transmitted by inhalation of spores that primarily presents with pulmonary symptoms, but disseminated disease may manifest in the skin, subcutaneous tissue, joints, bone, and meninges. It is common in its endemic regions of the southwest United States as well as parts of Mexico and South America. Case Presentation: We present a unique case of systemic coccidioidomycosis diagnosed after a tongue mass biopsy for suspected carcinoma revealed granulomatous inflammation and the presence of fungal organisms. The patient reported a recent self-limiting rash and a hospitalization one year prior due to presumed community-acquired bacterial pneumonia that may, in retrospect, have suggested fungal disease. This case demonstrates an important potential presentation of disseminated coccidioidomycosis that should be included in dermatologists’ differential diagnoses for non-healing tongue masses.