A scalp to make you squirm: Cutaneous myiasis hiding a unique presentation of disseminated coccidioidomycosis.

Coccidioidomycosis is predominantly a pulmonary disease, however dissemination can include unique cutaneous presentations. We report a previously healthy 11-year-old female with delayed diagnosis of cutaneous scalp coccidioidomycosis with disseminated disease with secondary wound myiasis and bacterial superinfection. She required extensive surgical debridement, eventually requiring a skin graft and prolonged hospitalization for antifungal therapy, experiencing a unique adverse effect.