COCCIDIOIDAL INFECTION OF THE THYROID

Infection of the thyroid gland with Coccidioides immitis, the causativ e agent of coccidioidomycosis, is very rarely recognized antemortem. W e report 2 recent cases, one immunosuppressed by corticosteroid treatm ent of sarcoidosis and. the other without any recognized impairment of host defenses. In the first case, thyroid gland involvement was but 1 indication of disseminated infection, In the second case, the patient appeared to have autoimmune thyrotoxicosis without clinical evidence of coccidioidomycosis is elsewhere. Although historical autopsy studie s have indicated that coccidioidal involvement of the thyroid gland ca n infrequently occur as part of fatal disseminated infection, to our k nowledge only 2 other cases of infection detected during life have bee n reported. Optimal treatment of this rare complication of coccidioido mycosis is uncertain.