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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
PubMed
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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.

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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.