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[Peritoneal coccidioidomycosis]
David Esmer-Sánchez1, Alejandro Alfaro-Sousa, Fernando Alvarez Tostado-Fernández
1Departamento de Cirugía, Centro Medico del Potosí-Hospital Angeles de San Luis Potosí. esmer_david@hotmail.com
Revista De Gastroenterologia De Mexico
|October 25, 2006
Summary
Coccidioidal peritonitis is a rare fungal infection, often found incidentally in immunocompromised individuals. This case highlights its presentation as chronic abdominal pain, successfully treated with fluconazole.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Gastroenterology
Background:
- Peritonitis is a rare condition, predominantly affecting immunocompromised patients and those undergoing peritoneal dialysis.
- Fungal peritonitis, particularly coccidioidal peritonitis, is exceptionally uncommon.
Observation:
- A 50-year-old female presented with a six-month history of intermittent right upper quadrant abdominal pain, nausea, and vomiting.
- Physical examination revealed localized tenderness in the right upper quadrant. Initial ultrasound suggested gallbladder pathology.
Findings:
- Exploratory laparoscopy identified diffuse lesions throughout the peritoneal cavity.
- Biopsies confirmed the presence of coccidioidomycosis, leading to a diagnosis of coccidioidal peritonitis.
- The patient was treated with fluconazole and showed an unremarkable recovery over three years.
Implications:
- This case underscores that coccidioidal peritonitis can manifest as chronic abdominal pain, even in non-immunocompromised individuals.
- Early diagnosis and appropriate antifungal treatment are crucial for favorable outcomes.
- Highlights the importance of considering fungal infections in the differential diagnosis of unexplained abdominal pathologies.
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