Coccidioidomycosis : Differential

Differential Diagnosis of Coccidioidomycosis: The spherules of Rhinosporidiosis and adiaspiromycosis are larger (200 to 400 μm) in contrast to coccidioides spherules (100 μm in diameter). In addition, the clinical presentation and histologic features are different than coccidioidomycosis. The endospores of coccidiodes resemble histoplasma, cryptococcus, and Blastomyces; however, the latter 3 show budding yeast forms and lack spherules. Coccidioides spherules also have to be differentiated from pollen grains and pulses (legume seeds).

The image shows BCG-like granulomas in a wedge resection of lung from a patient with pulmonary coccidioidomycosis.