- Lung parenchyma and pleural space
- Inhaled when spores stirred up by construction, gardening, wind, dry season in Southwest US, Mexico
- Diabetes and other immunocompromised states
- Persons from the Philippines/Pacific Islands
- 60% have mild or no sx
- Can have acute pneumonia w/f, cough, sob, sputum, pleuritic cp
- Can also have sub-acute sob
- Skin eruptions that can be painful, red, flat or raised
- Decreased breath sounds/dullness if effusion
- Sometime skin fidings of: erythema nodosum→ painful red nodules, erythema multiforme→ erythematous eruption, often w/central clearing, skin nodules, or papular rash; adenopathy
- Inflammatory arthritis, osteomyelitis
- Peripheral eosinophilia that's otherwise unexplained
- Cocci serologies (ELISA based qualitative assessment for IgM, IgG) - may be negative during very acute phase, w/need to repeat
- Cocci complement fixation (IgG titre), typically don in f/u to serologies