Unexpected coccidioidomycosis presenting as lung nodules with presumptive diagnosis of malignancy

Key clinical message Coccidioidomycosis can present as fluorodeoxyglucose (FDG) avid lung nodules which may be mistaken as relapse in patients with a history of malignancy. Detailed clinical history, relevant laboratory testing, and/or tissue biopsy with histologic evaluation are necessary for correct diagnosis. Unexpected coccidioidomycosis presenting as lung nodules in a patient with a history of malignancy.