Peritoneal and genital coccidioidomycosis in an otherwise healthy Danish female: a case report

TY - JOUR

T1 - Peritoneal and genital coccidioidomycosis in an otherwise healthy Danish female

T2 - a case report

AU - Bæk, Ole

AU - Astvad, Karen

AU - Serizawa, Reza

AU - Wheat, Lawrence J.

AU - Brenøe, Pia T.

AU - Hansen, Ann Brit E.

PY - 2017/1/31

Y1 - 2017/1/31

N2 - Background: Coccidioidomycosis is a fungal infection that usually presents as a primary lung infection. The fungus is endemic to the Southwest United States of America, northern Mexico and parts of Central and South America the infection is rare outside these areas. However, some patients develop disseminated infection that can lie dormant for several years and can present itself in travelers. We report the first case of extra pulmonary Coccidioidomycosis in a non-immunocompromised individual in Denmark. Case presentation: A 32 year old Danish woman presented at the Emergency department with abdominal pain. Computed tomography scan and ultrasound examination of the pelvis raised suspicion of salpingitis. A laparoscopy exposed a necrotic salpinx and several small white elements that resembled peritoneal carcinomatosis. Histological workup however determined that she suffered from disseminated coccidioidomycosis. The patient had lived 2 years in Las Vegas, in the United States of America, 7 years prior and had no memory of lung infection at the time. Conclusions: Disseminated coccidioidomycosis is rare in non-immunocompromised individuals. The patient in this case underwent several rounds of in vitro fertilization treatment in the years before admittance. We suspect that the hormonal treatment in combination with low-dose prednisolone may have triggered reemergence of the disease and present literature that support this.

AB - Background: Coccidioidomycosis is a fungal infection that usually presents as a primary lung infection. The fungus is endemic to the Southwest United States of America, northern Mexico and parts of Central and South America the infection is rare outside these areas. However, some patients develop disseminated infection that can lie dormant for several years and can present itself in travelers. We report the first case of extra pulmonary Coccidioidomycosis in a non-immunocompromised individual in Denmark. Case presentation: A 32 year old Danish woman presented at the Emergency department with abdominal pain. Computed tomography scan and ultrasound examination of the pelvis raised suspicion of salpingitis. A laparoscopy exposed a necrotic salpinx and several small white elements that resembled peritoneal carcinomatosis. Histological workup however determined that she suffered from disseminated coccidioidomycosis. The patient had lived 2 years in Las Vegas, in the United States of America, 7 years prior and had no memory of lung infection at the time. Conclusions: Disseminated coccidioidomycosis is rare in non-immunocompromised individuals. The patient in this case underwent several rounds of in vitro fertilization treatment in the years before admittance. We suspect that the hormonal treatment in combination with low-dose prednisolone may have triggered reemergence of the disease and present literature that support this.

KW - Case report

KW - Coccidioidomycosis

KW - Disseminated

KW - Fungus

KW - Traveller

U2 - 10.1186/s12879-017-2212-4

DO - 10.1186/s12879-017-2212-4

M3 - Journal article

C2 - 28143444

AN - SCOPUS:85011105468

SN - 1471-2334

VL - 17

JO - BMC Infectious Diseases

JF - BMC Infectious Diseases

M1 - 105

ER -