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A Case of Disseminated Coccidioidomycosis Presenting as Ascites in a Previously Healthy Middle-Aged Man

Year: 2025

Type: article

Abstract: We present a rare case of disseminated coccidioidomycosis in a previously healthy 47-year-old man with peritoneal involvement causing ascites. Diagnosis relied on serology and lung tissue histopathology with fungal culture. A large-volume paracentesis and initial fluconazole treatment resolved ascites and stabilized pulmonary lesions. However, relapse after discontinuation of treatment required dose escalation, leading to clinical and serologic improvement. This case expands clinical awareness of atypical presentations of coccidioidomycosis while reviewing the literature on patient demographics and diagnostic work-up in the limited number of previously reported cases.

Source: Annals of Internal Medicine Clinical Cases

DOI: 10.7326/aimcc.2025.0251

Authors: Lindsey C. Davis, Joel Quinones, Cyrus Askin

Institution: William Beaumont Army Medical Center

Language: English

Topic: Fungal Infections and Studies

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

Funders: U.S. Department of Defense, Defense Health Agency