ArticleJournal of surgical case reports2025
Disseminated peritoneal coccidioidomycosis mimicking malignancy in an immunosuppressed patient: a case report.
Article in Journal of surgical case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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