The evaluation of coccidioidomycosis will begin with a history and physical examination.

Physical findings in someone with coccidioidomycosis may include:

• Enlargement of the liver
• Enlargement of the spleen
• Erythema nodosum
• Hyperreflexia (increased reflexes)
• Rapid heart rate
• Rapid respiratory rate
• Rash
• Tenosynovitis

The diagnosis of coccidioidomycosis is confirmed by tissue biopsy or by culturing the fungus from sputum, a wound, or joint fluid.

Tests that may be used to evaluate coccidioidomycosis include:

• Serologic tests for antibodies are available but may take weeks to come back.
• Coccidioidomycosis skin test:
• This test turns positive at 3 weeks to 3 months after exposure.
• Complete blood count
• Chest x-ray:
• Normal chest x-ray
• Chest x-ray showing pneumonia
• Pulse oximetry
• Blood cultures
• Sputum culture:
• For bacteria and viruses
• Rapid influenza testing
• Urine antigen testing for pneumococcus or Legionella

Less commonly used tests that may be used to evaluate coccidioidomycosis include:

• Bronchoscopy:
• To obtain sputum for bacterial cultures
• Chest CT scan