**Core Concept**
Coccidioidomycosis is a fungal infection caused by *Coccidioides immitis*, which primarily affects the lungs. The treatment of choice for coccidioidomycosis involves antifungal medications that target fungal cell growth and replication.

**Why the Correct Answer is Right**
Fluconazole is a triazole antifungal agent that inhibits the cytochrome P450 enzyme lanosterol 14α-demethylase, which is essential for fungal cell growth and replication. By blocking this enzyme, fluconazole prevents the production of ergosterol, a critical component of fungal cell membranes. This results in fungal cell lysis and death, making fluconazole an effective treatment for coccidioidomycosis.

**Why Each Wrong Option is Incorrect**
**Option A:** Amphotericin B is a polyene antifungal agent that binds to ergosterol in fungal cell membranes, causing cell lysis. However, it is typically reserved for severe or life-threatening fungal infections due to its potential nephrotoxicity and requires a longer treatment duration compared to fluconazole.

**Option C:** Flucytosine is an antifungal medication that is converted into 5-fluorouracil within fungal cells, which then inhibits DNA synthesis and replication. While flucytosine can be used in combination with other antifungal agents to treat coccidioidomycosis, it is not the treatment of choice due to its narrow spectrum of activity and potential toxicity.

**Option D:** Griseofulvin is an antifungal medication that works by inhibiting fungal cell division and growth, but it is primarily effective against dermatophytes, not dimorphic fungi like *Coccidioides immitis*. Therefore, it is not an appropriate treatment for coccidioidomycosis.

**Clinical Pearl / High-Yield Fact**
When treating coccidioidomycosis, it is essential to consider the severity of the infection, the patient's immunocompromised status, and potential drug interactions. A combination of antifungal agents, such as fluconazole and flucytosine, may be used in severe cases to enhance treatment efficacy.

**✓ Correct Answer: B. Fluconazole**