Intrapartum Fever—Coccidioidomycosis Diagnosed During Induction of Labor: A Case Report
Year: 2026
Type: article
Study design: Case Report
Abstract: Background Coccidioidomycosis, also known as Valley fever or “cocci,” is an endemic fungal infection to southwestern United States. Coccidioidomycosis infections have an increased risk of severe disease progression in pregnancy, especially in the later trimesters and postpartum. Early recognition in pregnant patients is crucial for preventing complications. Clinical Case A 31‐year‐old female Gravida 2, Para 0, Abortus 1 at 37 weeks of gestation was admitted for labor induction due to cholestasis of pregnancy. Prenatal labs were unremarkable, Group B streptococcus (GBS) bacteria negative, and membranes intact. During the hospital course, the patient had periods of maternal tachycardia and reported a prior negative cardiac workup in the outpatient setting. She then developed a fever of 38.6°C, sustained despite acetaminophen and cooling measures. The fetal heart tracing (FHT) also showed fetal tachycardia, leading to suspected chorioamnionitis and initiating empiric antibiotic therapy with ampicillin and gentamicin. However, the fever persisted, and the infectious workup was expanded. Further history revealed that the patient had daily fevers for the past 3 weeks, along with a dry cough and dyspnea on exertion for the past 10 months prior to conception, necessitating various clinic and emergency department visits. Due to her occupation in agriculture, she was tested for coccidioidomycosis. Pharmacological induction was held until maternal and fetal stabilization, ultimately resulting in a spontaneous vaginal delivery of a healthy infant. Postpartum imaging showed diffuse interstitial lung changes, and serology confirmed active coccidioidomycosis infection. Fluconazole therapy was initiated, and the patient was discharged home on postpartum Day 2 with close follow‐up with infectious diseases. Conclusion This case underscores the need to consider coccidioidomycosis in pregnant patients, especially from endemic regions who present with persistent fevers and/or respiratory symptoms. Timely diagnosis and treatment are essential for managing infection and reducing maternal–fetal complications.
Institution: University of California, San Francisco
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $790
OpenAlex ID: W7135078153