Mature spherules in sputum sample is seen in which of the following?

Ref: Atlas of Infectious diseases: Fungal Infection, pg. 33* Mature spherule in sputum sample is seen in coccidiodomycosis.* Coccidioidomycosis may present with a syndrome of erythema nodosum, fever, and conjunctivitis. Serious complications include cavitating lung lesions or meningitis.* Coccidioides immitis grows readily on routine culture media. Unlike other dimorphic fungi, colonies usually are visually apparent within 3 to 5 days. On solid media, the fungus appears as a nonpigmented mold. Unlike specimens obtained from patients. C limitis growing in culture is highly infectious and represents an extreme laboratory hazard.FIGURE: Potassium hydroxide (KOH) preparation of sputum. The chitin in the spherule cell wall is resistant to digestion by KOH, whereas host cells in sputum are not. Two mature spherules are evident in the figure, one of which has ruptured and is releasing endospores. Although KOH is not a sensitive test, the finding of spherules in a sputum specimen is diagnostic of coccidioidomycosis.