Work

Disseminated peritoneal coccidioidomycosis mimicking malignancy in an immunosuppressed patient: a case report

Year: 2025

Type: article

Abstract: Disseminated peritoneal coccidioidomycosis is rare and can mimic peritoneal carcinomatosis. Ustekinumab, an IL-12/23 inhibitor, impairs Th1/Th17 immunity which is critical for fungal control. No prior cases link ustekinumab use to disseminated fungal disease. We report a 45-year-old woman from an endemic region with prior pulmonary coccidioidomycosis and psoriatic arthritis on ustekinumab who presented with malignant-appearing ascites and omental caking. Fluid studies were non-diagnostic, but laparoscopic biopsies confirmed disseminated Coccidioides infection. She improved with liposomal amphotericin B followed by oral fluconazole suppression. This case highlights the need to consider peritoneal coccidioidomycosis in immunosuppressed patients, particularly on IL-12/23 blockade, and underscores the role of tissue diagnosis when fluid studies are negative.

Source: Journal of Surgical Case Reports

DOI: 10.1093/jscr/rjaf978

Authors: Ryan Meyer, Tamir Bresler, Kevin Palmer, Makrouhi Kademian

Institution: Los Robles Hospital & 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: gold

Estimated APC paid: $1,000