Coccidioidomycosis is a systemic fungal disease caused by Coccidioides immitis and Coccidioides posadasii. The lungs are the most common and often the initial site of involvement, and the non-pulmonary presentation is infrequent. We describe an unusual case of primary craniocutaneous coccidioidomycosis in a pregnant woman with infected bilateral periorbital nodules, intense pain at paranasal sinuses, and several osteolytic skull lesions. The analysis of 54 cases available in the literature makes us suggest that the area between the United States and Mexico is a risk zone for primary cutaneous coccidioidomycosis.
Address correspondence to Jesús Salvador Velarde-Félix, Escuela de Biomedicina, Universidad Autónoma de Sinaloa, Av. de las Américas y Blvd., Universitarios s/n, Ciudad Universitaria, Culiacán 80230, Mexico. E-mail: email@example.com
Authors’ addresses: Carmina Galaviz-Aboytes, José Alejandro Alzate-Moctezuma, and José Rodríguez-Millán, Department of Internal Medicine, Hospital General de Culiacán “Bernardo J. Gastélum”, Culiacán, Mexico, E-mails: firstname.lastname@example.org, email@example.com, and firstname.lastname@example.org. Luis Antonio Ochoa-Ramírez, Genomic Medicine Center, Dr. Bernardo J. Gastélum Primary Care Hospital, Culiacan, Mexico, E-mail: email@example.com. Efrén Rafael Ríos-Burgueño, Department of Pathology, Center of Research and Teaching in Health Sciences (CIDOCS), Autonomous University of Sinaloa, Culiacan, Mexico, E-mail: firstname.lastname@example.org. Salvador Velarde-Félix, Genomic Medicine Center, Dr. Bernardo J. Gastélum Primary Care Hospital, Culiacan, Mexico, and Biomedicine School, Autonomous University of Sinaloa, Culiacán, Mexico, E-mails: email@example.com or firstname.lastname@example.org.