case_images: PMC11368141_01
case_images: (A-C) yellow arrows indicate patient's skin masses in the right neck, right upper arm, and back neck, some of which were crusted.
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case_images: Physical examination revealed two masses measuring 4x5 cm on the neck (Figure 1A and C), a mass measuring 4x3 cm on the left axilla, and three masses measuring 1x1 cm on the right upper arm that were firm to touch (Figure 1B).
case_images: (A-F) Chest CT and bronchoscope. A and B indicate infectious lesions in both lungs. (C and D) yellow arrows show local bone destruction in the left 4th rib and flaky axillary low-density shadows. (E and F) show chronic inflammatory changes in the bilateral bronchus with mild stenosis of some lumens, tubercles, and right middle lobe mucous tubercles.
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case_images: The largest layer was located in the axilla, with a range of 7.6x4.7 cm (Figure 2A-D). Bronchoscopy showed no special features, only chronic inflammatory changes (Figure 2E and F). 
case_images: (A-D) Spinal MRI yellow arrows indicate abnormal signals in the thoracic vertebrae, lumbar vertebrae, sacrum and bilateral ilium, and abscess formation around the sacroiliac joint.
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case_images: An abscess formed around the right sacroiliac joint and bilateral hip joints (Figure 3A-D).  We followed the patient, after one year of antifungal treatment, the symptoms improved obviously, the pulmonary symptoms were basically relieved, the skin mass disappeared, the bone pain was relieved, and MRI showed that the bone destruction was improved (Figure 4A and B compare with Figure 3A and B).
case_images: (A and B) Spinal MRI yellow arrows indicate that abnormal signals of the thoracic and lumbar vertebrae are significantly reduced compared with (Figure 3A and B).
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case_images: We followed the patient, after one year of antifungal treatment, the symptoms improved obviously, the pulmonary symptoms were basically relieved, the skin mass disappeared, the bone pain was relieved, and MRI showed that the bone destruction was improved (Figure 4A and B compare with Figure 3A and B).