Coccidioidal Peritonitis: A Review of 17 Cases

Royce H Johnson; Ritika Sharma; Rupam Sharma; Valerie Civelli; Vishal Narang; Rasha Kuran; Ellie J C Goldstein; Stan Deresinski; Amber Jones; Amin Ramzan; Irving Posalski; Dena El-Sayed; George R Thompson 3rd; Carlos D'Assumpcao; Arash Heidari

doi:10.1093/ofid/ofac017

Coccidioidal Peritonitis: A Review of 17 Cases

Open Forum Infect Dis. 2022 Jan 19;9(3):ofac017. doi: 10.1093/ofid/ofac017. eCollection 2022 Mar.

Authors

Royce H Johnson^{1

2

3}, Ritika Sharma^{1

2}, Rupam Sharma^{1

2}, Valerie Civelli^{1

2}, Vishal Narang^{1

2

3}, Rasha Kuran^{1

2

3}, Ellie J C Goldstein^{3

4}, Stan Deresinski⁵, Amber Jones⁶, Amin Ramzan⁷, Irving Posalski⁸, Dena El-Sayed⁹, George R Thompson 3rd^{10

11}, Carlos D'Assumpcao^{1

2

3}, Arash Heidari^{1

2

3}

Affiliations

¹ Department of Medicine, Division of Infectious Diseases, Kern Medical, Bakersfield, California, USA.
² Valley Fever Institute, Bakersfield, California, USA.
³ Department of Medicine, David Geffen School of Medicine UCLA, Los Angeles, California, USA.
⁴ R.M. Alden Research Laboratories, Santa Monica, California, USA.
⁵ Clinical Professor of Medicine, Department of Medicine/Infectious Diseases, Stanford University, Stanford, California, USA.
⁶ Department of Surgery, Kern Medical, Bakersfield, California, USA.
⁷ Department of OB/GYN, Kern Medical, Bakersfield, California, USA.
⁸ Division of Infectious Diseases, Cedars Sinai, Los Angeles, California, USA.
⁹ Division of Infectious Diseases, Ventura County Medical Center, Ventura, California, USA.
¹⁰ Department of Internal Medicine, Division of Infectious Diseases, University of California Davis Medical Center, Sacramento, California, USA.
¹¹ Department of Medical Microbiology and Immunology, University of California Davis, Davis, California, USA.

Abstract

Coccidioidomycosis is the second most common endemic fungal infection in the United States. Prior descriptions of coccidioidal peritonitis include only single cases. We describe 17 new cases previously unreported from healthcare institutions in California. The majority of cases presented with nonspecific abdominal complaints. PubMed and Google Scholar were searched for additional case series and only single case reports and reviews of single cases were found. The diagnosis was confirmed by culture or histopathology and/or serology in each patient. All patients were treated with anti-fungal therapy. This case series demonstrates that coccidioidal peritonitis may be asymptomatic or present with only subtle abdominal symptoms. In a minority of our patients, the diagnosis was established incidentally during surgery. Based on this series, the overall outcome of coccidioidal peritonitis is favorable with long-term triazole treatment. The term cure is not usually used in disseminated coccidioidal disease because of the risk of late relapse.

Keywords: coccidioidal peritonitis; peritoneal coccidioidomycosis and omental caking; peritonitis.

Publication types

Review