DISSEMINATED COCCIDIOIDOMYCOSIS ASSOCIATED WITH EXTREME EOSINOPHILIA

Primary coccidioidomycosis is frequently accompanied by eosinophilia i n the range of 5%-10% of the peripheral white blood cell count. Dissem ination of Coccidioides immitis to organs such as skin, bone, joints, and CNS usually is associated with risk factors such as sex (male), ra ce (non-Caucasian), pregnancy, and immunosuppression. We report a case of coccidioidomycosis in an otherwise healthy African-American man wi th 72% eosinophilia who had dissemination to the skin, and we review c ases in the literature of disseminated disease associated with eosinop hilia. Marked eosinophilia may be an important early clue that dissemi nation of coccidioidomycosis has occurred.