Peritoneal Coccidioidomycosis

An Argentine pathologist, Robert Wernicke,⁵first described coccidioidomycosis in 1892. Since then, the pathogenesis and clinical manifestations of the disease have been presented many times.²Its clinical similarity to tuberculosis is noted repeatedly in the literature. However, one of the outstanding differences is the infrequent involvement of the gastrointestinal tract and peritoneum. Forbus²explained this infrequency as due to less inflammatory reaction associated with the pulmonary lesions, resulting in little or no sputum production. This, in turn, produces less infected sputum which might be swallowed and thus involve the gastrointestinal tract. Intestinal lesions have only rarely been reported in autopsy material.^2,3Collins¹found histological evidence of coccidioidomycosis as an incidental finding in 11 out of 50,000 vermiform appendices. Ruddock and Hope⁴reported a case in an Oriental who was thought to have liver cirrhosis, but peritoneoscopy showed miliary tubercles of