Coccidioidomycosis is a common infectious disease in southwestern North America, which is caused by the soil fungus, Coccidioides immitis. Due to the mobility of the modern population , increasing numbers of cases are being diagnosed outside the endemic areas. Moreover, diagnosis in non-endenmic areas may be delayed or confused due to its rarity. Here we report a case of pulmonary coccidioidomycisis in an immigrant. The patient presented with unexplained pulmonary symptoms. A history of recent travel to or immigration from an endemic area may suggest coccidioidomycosis. In addition an early tissue biopsy is helpful in establishing this diagnosis.