Coccidioidomycosis is an endemic fungal infection that rarely presents as isolated osteoarticular disease in immunocompetent hosts. We report a case of disseminated coccidioidomycosis manifesting as chronic septic arthritis of the tibiofemoral joint without apparent pulmonary involvement in a 32-year-old male. Diagnostic delay and initial immunosuppressive therapy contributed to disease progression. Histopathology confirmed the diagnosis and combined surgical debridement and prolonged antifungal therapy led to favorable outcomes. This case highlights the importance of considering fungal etiologies in chronic monoarthritis in endemic regions.
Keywords: Antifungal therapy; Coccidioidomycosis; Knee joint spacer; Orthopedic surgery; Osteoarticular mycosis; Septic arthritis.
© 2026 Published by Elsevier B.V. on behalf of International Society for Human and Animal Mycology.