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Coccidioidal Peritonitis: Clinical Characteristics, Treatment and Outcomes

Jamilah L Shubeilat1, Sandhya R Nagarakanti1, Abeer Almajali1

  • 1Division of Infectious Diseases, Mayo Clinic Arizona, Phoenix, AZ 85045, USA.

Journal of Fungi (Basel, Switzerland)
|July 27, 2026
PubMed

Insights

Peritoneal coccidioidomycosis, a rare fungal infection, shows favorable outcomes with antifungal therapy. Most patients responded well, with relapses uncommon and successfully retreated.

Area of Science:

  • Infectious Diseases
  • Mycology
  • Gastroenterology

Background:

  • Peritoneal coccidioidomycosis is a rare disseminated form of Coccidioides infection.
  • Limited literature exists on this specific manifestation.
  • This study reviews a significant case series from a single institution.

Purpose of the Study:

  • To analyze outcomes and treatment strategies for peritoneal coccidioidomycosis.
  • To evaluate the efficacy of antifungal therapy in affected patients.
  • To identify prognostic factors and treatment challenges.

Main Methods:

  • Retrospective review of 37 proven or probable cases of peritoneal coccidioidomycosis.
  • Analysis of patient demographics, including immunosuppression status.
  • Evaluation of antifungal treatment regimens, duration, adverse effects, and outcomes.
  • Monitoring for relapses and long-term follow-up.

Main Results:

  • 37 cases were identified, with 32% of patients being immunosuppressed.
  • All 36 treated patients showed clinical response to antifungal therapy.
  • Relapse occurred in 5% of patients who completed therapy, with successful retreatment.
  • 13 patients (35%) required regimen modification due to azole adverse effects.
  • Treatment duration averaged 57 months, similar for immunosuppressed and non-immunosuppressed groups.
  • No deaths were attributed to the infection.

Conclusions:

  • Peritoneal coccidioidomycosis demonstrates favorable outcomes with azole antifungal therapy.
  • Close monitoring and prompt management of adverse effects are crucial.
  • Patients without significant risk factors may achieve good prognosis with appropriate antifungal management.
  • Indefinite azole therapy may not always be necessary for favorable outcomes.
Keywords:
Coccidioidesantifungal treatmentcoccidioidomycosisdisseminated infectionperitonealperitonitis

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