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Blood count and serum chemistry studies initially demonstrated leukocytosis, anaemia, hyponatraemia and acute renal failure. Chest imaging revealed numerous small pulmonary nodules and skin biopsy, serological studies and blood cultures eventually confirmed disseminated infection with <jats:italic>Coccidioides immitis<\/jats:italic>. This case highlights important features regarding the risk factors, spectrum of clinical findings, evaluation and treatment of coccidioidomycosis relevant to providers in endemic areas and throughout the world.<\/jats:p>","DOI":"10.1136\/bcr-2014-205333","type":"journal-article","created":{"date-parts":[[2014,9,16]],"date-time":"2014-09-16T06:18:34Z","timestamp":1410848314000},"page":"bcr2014205333","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Beyond the superficial: <i>Coccidioides immitis<\/i> fungaemia in a man with fever, fatigue and skin nodules: a case of an emerging and evolving pathogen"],"prefix":"10.1136","volume":"2014","author":[{"given":"Charles","family":"Langelier","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of California San Francisco, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjiv M","family":"Baxi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, University of California San Francisco, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Iribarne","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Mt. 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