Coccidioidal Peritonitis: A Review of 17 Cases

Area of Science:

• Mycology
• Infectious Diseases
• Gastroenterology

Background:

• Coccidioidomycosis is a significant endemic fungal infection in the United States.
• Coccidioidal peritonitis is rarely described, with previous reports limited to single cases.
• This study addresses the lack of comprehensive data on coccidioidal peritonitis.

Purpose of the Study:

• To describe a series of coccidioidal peritonitis cases.
• To characterize the clinical presentation and diagnostic methods for coccidioidal peritonitis.
• To evaluate treatment outcomes for coccidioidal peritonitis.

Main Methods:

• A retrospective case series of 17 patients with coccidioidal peritonitis from California healthcare institutions.
• Literature search of PubMed and Google Scholar for existing case series and reports.
• Diagnosis confirmed via culture, histopathology, and/or serology.
• Treatment involved antifungal therapy, primarily long-term triazoles.

Main Results:

• Seventeen new cases of coccidioidal peritonitis were identified.
• Most patients presented with nonspecific abdominal complaints; some cases were incidental findings during surgery.
• Diagnosis was confirmed using microbiological and serological methods.
• All patients received antifungal treatment.

Conclusions:

• Coccidioidal peritonitis can be asymptomatic or present with subtle symptoms.
• The overall prognosis for coccidioidal peritonitis is favorable with appropriate antifungal therapy.
• Long-term management is crucial due to the potential for late relapses in disseminated coccidioidal disease.