Coccidioidomycosis — SCE Infectious Diseases MCQ

Correct answer: C — Reactive erythema nodosum, an immune manifestation rather than cutaneous dissemination with review

The best answer is “Reactive erythema nodosum, an immune manifestation rather than cutaneous dissemination with review”. Erythema nodosum is a sterile immune reaction accompanying primary coccidioidomycosis; disseminated skin disease contains fungal elements and has different implications. “Sweet syndrome proved by neutrophils in blood” is less appropriate because it conflicts with the clinical discriminator or cited guidance. “Disseminated cutaneous coccidioidomycosis despite absent organisms” is less appropriate because it conflicts with the clinical discriminator or cited guidance. “Concurrent sarcoidosis proved by hilar nodes” is less appropriate because it conflicts with the clinical discriminator or cited guidance. “Lupus pernio” is less appropriate because it conflicts with the clinical discriminator or cited guidance.

Reference: IDSA coccidioidomycosis guideline: https://www.idsociety.org/practice-guideline/coccidioidomycosis/ British HIV Association opportunistic-infection guidelines: https://bhiva.org/clinical-guideline/oi-guidelines/