University of Wisconsin–Madison Medical College of Wisconsin

Disseminated Coccidioidomycosis With Fungemia and Possible Strongyloides Co-infection

Julie Jerabek, MD; Ahmed Abdulrahim, MBBCh; Stephen Cavalieri, PhD; Kelsey Witherspoon, MD; Rima El-Herte, MD

WMJ. 2023;122(3):200-204

Download full-text pdf.


Introduction: Coccidioidomycosis is most often an asymptomatic or mild self-limited respiratory infection, but in rare cases it can become disseminated and cause severe disease.

Case Presentation: A 29-year-old man who was originally from Thailand and had been living in Arizona for 2 years presented with intermittent fevers, fatigue, and other nonspecific symptoms, including abdominal pain, nonbloody diarrhea, and pruritic rash. Initial laboratory values showed significant peripheral eosinophilia. Extensive evaluation revealed possible Strongyloides species infection. Shortly after, Coccidioidies species fungemia was found. Fevers and symptoms resolved after adequate treatment.

Discussion: Disseminated coccidioidomycosis with fungemia is very rare in immunocompetent individuals. Co-infection with Stronglyloides species is only reported in two other case reports.

Conclusions: We report this case to raise awareness of a rare infection. In adequate epidemiological circumstances, co-infections Coccidioides and Strongyloides species should be considered in presence of fever and eosinophilia.

Author Affiliations: Division of Infectious Diseases, Department of Medicine, Creighton University School of Medicine and CHI Health, Omaha, Nebraska (Jerabek, Witherspoon, El-Herte); Department of Pathology, Creighton University School of Medicine and CHI Health, Omaha, Neb (Abdulrahim, Cavalieri).
Corresponding Author: Julie Jerabek, Creighton University School of Medicine, 7710 Mercy Rd, Suite 3000, Omaha, NE 68124; phone 402-717-0759; email; ORCID ID 0009-0009-0074-4599
Funding/Support: None declared.
Financial Disclosures: None declared.
Share WMJ