Coccidioidomycosis of the temporal fossa with intracranial extension

Coccidioidomycosis is a fungal infection endemic to the arid Southwestern United States. It is contracted initially as a pulmonary disease when coccidioides immitus spores found in soil are inhaled. Disseminated disease occurs primarily in the immunocompromised population. We present herein a case of disseminated coccidioidomycosis presenting as a temporal fossa lesion extending intracranially. Our patient showed a robust response to antifungal therapy that obviated the need for surgical intervention.