Gastrointestinal dissemination of coccidioidomycosis

An unusual case of extensive gastrointestinal involvement by the fungus Coccidioides immitis is reported in a 21-yr-old man. This unique case demonstrates the occurrence of this fungus within chylous ascites, the mesentery, and invasion of the entire length of the small bowel. Histological and cultural documentation for gastrointestinal tract involvement by C. immitis other than for the rare occurrence of peritonitis has not been previously reported. The significance of the disseminated gastrointestinal coccidioidomycosis in the setting of chylous ascites and extensive abdominal lymphatic involvement is discussed with respect to its pathogenesis and treatment.