Coccidioidomycosis, for several decades recognized as an endemic infectious disease in the southwestern portion of the United States, is being recognized as a worldwide affliction. Its spread in this country is due primarily to contraction of the disease by members of the Armed Forces while stationed in the endemic area during World War II. Bone and joint involvement during the disseminated stage of the disease is the exception, rather than the rule. Its occasional appearance, however, demands that the orthopaedic surgeon be sufficiently familiar with its manifestations and behavior to recognize the condition when he is confronted wth it.
Coccidioidomycosis is a deep mycotic infection caused by the fungus Coccidioides immitis. The initial, or primary, phase is usually a self-limited pulmonary infection.* This may be a comparatively innocuous, subclinical condition. It is sometimes accompanied by chills, fever, malaise, headache, and multiple joint pains. Symptoms and signs of pleural involvement are