Monoarticular coccidioidal synovitis in a pediatric patient.

Isolated monoarticular synovitis is a rare presentation of coccidioidal disease and has, to our knowledge, never previously been described in the English language pediatric literature. Coccidioidal seropositivity is increasing in incidence in the Southwestern United States. It is critical to rule out Coccidioides infection when evaluating arthritis in the context of residence in or travel to high prevalence areas, even in otherwise healthy patients and especially before administering biologic immunosuppressive therapy.