Coccidioidomycosis is endemic to the southwestern United States, Mexico, Central America, and South America. In endemic areas, the risk of exposure to Coccidioides immitis is estimated to be approximately 3% per year. The annual number of infections has risen to approximately 150,000 as a result of population increases in Arizona and central California. Coccidioidomycosis is primarily a lung infection with secondary dissemination to bone. Osseous involvement may occur in 10% to 30% of patients. Common osseous sites involve the spine, patellae, metacarpals, metatarsals, carpal bones, and the diaphysis of long bones. However, bone infections of the hand usually occur in children. Here, we report the case of a man with coccidioidal osteomyelitis of the fifth metacarpal. Our patient reviewed the manuscript for this case report and provided informed, written consent for us to publish it in print and electronically.
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