Coccidioidomycosis mimicking peritoneal carcinomatosis
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A 43-year-old previously healthy female presented to her primary care physician with a two-week history of 10-lb weight gain, increased abdominal girth, abdominal pain, and fatigue. Her past medical history was largely unremarkable. A bedside ultrasound revealed large-volume ascites. Aspirated ascitic fluid did not yield malignant cells, and cultures were negative for mycobacterial, acid-fast bacilli, or aerobic and anaerobic bacteria. The CT and MRI of chest, abdomen, and pelvis demonstrated lymphadenopathy, including enlarged hilar lymph nodes, large-volume abdominal ascites, omental caking and multiple enhancing nodules along the peritoneal lining. Additionally, it revealed an enhancing nodule within the rectus muscle. Endobronchial ultrasound guided biopsy of the hilar nodes was negative for malignant cells, no granulomatous disease was identified.Investigations findings confirmed the diagnosis - Disseminated coccidioides infection.

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