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report describes an unusual presentation of a man with a testicular mass who
presented in diabetic ketoacidosis to the emergency department. Initial
diagnosis was a suspected testicular malignancy based on history, physical
exam, and available laboratory and radiological imaging. Due to the possibility
of a testicular malignancy, the patient was taken for immediate orchiectomy.
Histology revealed coccidioido-mycosis of the left testicle and epididymis.
Treatment with the appropriate antifungals was initiated. Despite aggressive
multi-disciplinary therapy the patient continued to deteriorate and eventually
expired as a result of the massive systemic infection. Literature review
revealed the presentation of disseminated genitourinary coccidioidomycosis is rare
and seldom reported.