Coccidioidomycosis of the tongue.

A Spanish-speaking farm worker with type 2 diabetes mellitus presented to our institution with an ulcerating tongue lesion. He was initially evaluated for possible squamous cell carcinoma; however, histologic examination revealed coccidioidomycosis. Coccidioidal titers were elevated and consistent with disseminated disease, although the patient had no systemic symptoms and clinical evaluation was negative. He was ultimately treated with intravenous and oral antifungal medication, which was followed by improvement of his tongue lesion.