title: Abdominal/pelvic Coccidioidomycosis.
abstract: BACKGROUND
  Coccidioidomycosis is the second most common endemic fungal infection in the southwestern United States. Rarely, this fungal infection exhibits symptoms suggestive of peritoneal malignancy, such as ascites and abdominal pelvic masses.
  
  
  METHODS
  We present a case involving a 51-year-old woman who presented with abdominal pain, ascites, and elevated serum CA-125 levels in 1995. She underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Final pathology revealed Coccidioidomycosis. Following prolonged treatment with fluconazole, her fungal symptoms resolved completely.
  
  
  CONCLUSIONS
  Patients with Coccidioidomycosis have a good prognosis if they are optimally diagnosed and treated. Ascites and elevated serum CA-125 levels associated with Coccidioidomycosis are not documented in the literature. Although extremely rare, abdominal Coccidioidomycosis could be considered in the differential diagnosis in patients who present with ascites or elevated serum CA-125 levels.
authors.affiliation: Gynecologic Oncology Associates, Hoag Cancer Center, 351 Hospital Road, Suite 507, Newport Beach, CA 92663, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Micha
authors.forename: Bram H
authors.initials: BH
authors.lastname: Goldstein
authors.forename: Philip A
authors.initials: PA
authors.lastname: Robinson
authors.forename: Mark A
authors.initials: MA
authors.lastname: Rettenmaier
authors.forename: John V
authors.initials: JV
authors.lastname: Brown
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D018394:CA-125 Antigen / Q000097:blood; D003047:Coccidioidomycosis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000175:diagnosis
chemical_list: D000935:Antifungal Agents; D018394:CA-125 Antigen; D015725:Fluconazole