Disseminated Coccidioidomycosis Presenting as Prostatic Abscess in Poorly Controlled Diabetes

Shah VD, Gao Y, Lim L, Chatta P, Rogstad D and Kazbour H

Department of Internal Medicine, Olive View-UCLA/Cedars-Sinai/Kaiser Sunset, USA
Department of Internal Medicine, Loma Linda University Medical Center, USA
Department of Internal Medicine, University of Alabama at Birmingham, USA

^*Correspondance to: Yinglin Gao 

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Abstract:

Background: Coccidioidomycosis infection classically presents as a pulmonary illness. Disseminated coccidiomycosis affects approximately 1% of patients. Most common extrapulmonary sites are skin, bones, central nervous system, and soft tissue. Even more rare is the presentation of symptomatic genital tract infections and prostatitis. We present a rare case of disseminated coccidioidomycosis in a 60-year-old male with poorly controlled diabetes and Polycythemia Vera (PV) who presented with dysuria and suprapubic tenderness found to have a prostate abscess, splenic lesions and cavitary pneumonia. Case Report: A 60-year-old man with a history of uncontrolled type 2 diabetes mellitus (hemoglobin A1c 12.5%) and myocardial ischemia, presented with a three-week history of suprapubic abdominal pain, dysuria, unintentional 25-lb weight loss, and left lower leg numbness and weakness. He is a truck driver in Southern California delivering goods to construction sites. Computed Tomography (CT) scan of the chest, abdomen and pelvis revealed prostatic abscess, splenic abscess, cavitary right upper lobe opacities. Cultures of his prostatic and bronchoalveolar lavage fluid grew Coccidioides immitis, and serum Coccidioides serology by immunodiffusion were positive for IgM and IgG, confirming disseminated coccidioidomycosis. Conclusion: Disseminated Coccidioidomycosis should be on the differentials on patients who presents with dysuria in endemic area.

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Cite the Article:

Shah VD, Gao Y, Lim L, Chatta P, Rogstad D, Kazbour H. Disseminated Coccidioidomycosis Presenting as Prostatic Abscess in Poorly Controlled Diabetes. Clin Case Rep Int. 2023; 7: 1538.