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The patient had positive coccidioidomycosis serologies and he was started on fluconazole with resolution of symptoms and improvement in transaminitis over the next month. This article highlights a rare manifestation of disseminated coccidioidomycosis with symptomatic hepatitis. Although an increasingly prevalent infection found in southwest USA, dissemination is rare in immunocompetent hosts. Postmortem studies suggest hepatic involvement is common in disseminated infection. However symptomatic hepatitis is rare, with only three cases of symptomatic hepatitis found in the literature.<\/jats:p>","DOI":"10.1136\/bcr-2013-202144","type":"journal-article","created":{"date-parts":[[2014,4,15]],"date-time":"2014-04-15T06:43:10Z","timestamp":1397544190000},"page":"bcr2013202144","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Symptomatic hepatitis secondary to disseminated coccidioidomycosis in an immunocompetent patient"],"prefix":"10.1136","volume":"2014","author":[{"given":"Mikhail","family":"Kuprian","sequence":"first","affiliation":[{"name":"Madigan Army Medical Center, Tacoma, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Schofield","sequence":"additional","affiliation":[{"name":"Madigan Army Medical Center, Tacoma, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Bennett","sequence":"additional","affiliation":[{"name":"Madigan Army Medical Center, Tacoma, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,4,15]]},"reference":[{"key":"2025082802232846000_2014.apr15_1.bcr2013202144.1","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1155\/2007\/502015","article-title":"Eosinophilic pneumonia in a traveller returning from Mexico","volume":"18","author":"Hajek","year":"2007","journal-title":"Can J Infect Dis Med Microbiol"},{"key":"2025082802232846000_2014.apr15_1.bcr2013202144.2","first-page":"217","article-title":"Increase in reported coccidioidomycosis\u2014United States, 1998\u20132011","volume":"62","author":"Centers for Disease Control and Prevention (CDC)","year":"2013","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025082802232846000_2014.apr15_1.bcr2013202144.3","doi-asserted-by":"publisher","DOI":"10.1086\/496991"},{"key":"2025082802232846000_2014.apr15_1.bcr2013202144.4","first-page":"171","article-title":"Disseminated coccidioidomycosis. 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