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Coccidioides immitis is a fungus found in the soil in certain arid areas of the Western Hemisphere. Its clinical presentation ranges from varied pulmonary and cutaneous manifestations, to lesions affecting virtually every organ and tissue. Diagnosis can be established by demonstration of the organism or by use of serologic tests. Antifungal therapy is effective for disseminated disease and some cases of acute primary infection. Surgical therapy is indicated for infection in certain pulmonary, osseous, articular, and soft tissues.