title: Unsuspected, disseminated coccidioidomycosis without maternofetal morbidity diagnosed by placental examination: case report and review of the literature.
abstract: Historically, untreated disseminated coccidioidomycosis during pregnancy was thought to be associated with 100% maternal fatality and 50% fetal mortality and was the leading cause of maternal deaths in areas of endemicity. As recently as 1995, therapeutic abortions and early deliveries were advocated in certain contexts. This report describes an unrecognized case of disseminated coccidioidomycosis diagnosed at the time of placental examination in a woman who completed her pregnancy without significant maternofetal complications. This case suggests that abortion and early delivery may not be necessary, because the possibility of an uncomplicated pregnancy exists. It is likely that other similar cases exist but remain underreported or underdiagnosed because of the mild, nondescript nature of the illness and low clinical suspicion. Although this mother and infant had good clinical outcomes, thorough travel histories and consideration of the associated travel-related diseases are important because of the possibility of serious, potentially avoidable clinical consequences.
authors.affiliation: Department of Pathology, University of Texas Southwestern Medical Center at Dallas, Dallas 75390-9073, USA.
authors.forename: Christina A
authors.initials: CA
authors.lastname: Arnold
authors.forename: Dinesh
authors.initials: D
authors.lastname: Rakheja
authors.forename: Michael A
authors.initials: MA
authors.lastname: Arnold
authors.forename: John M
authors.initials: JM
authors.lastname: Peters
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Fernandes
authors.forename: Norma M
authors.initials: NM
authors.lastname: Quintanilla
authors.forename: Arthur G
authors.initials: AG
authors.lastname: Weinberg
authors.forename: Paula
authors.initials: P
authors.lastname: Revell
authors.forename: Dominick C
authors.initials: DC
authors.lastname: Cavuoti
mesh_terms: D000328:Adult; D003047:Coccidioidomycosis / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission*; D005260:Female; D006801:Humans; D009017:Morbidity; D010920:Placenta / Q000382:microbiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology