COCCIDIOIDAL PERITONITIS: DIAGNOSIS BY PERITONEOSCOPY

This case is unique in that it is the first case of coccidioidal peritonitis reported in the literature in which a diagnosis was proved before death. Coccidioidal granuloma is a rare disease and one peculiar to the San Joaquin Valley in California. The first human infection was reported by Wernicke¹ in 1892, and the organism was described as a protozoa. In 1900 Ophuls and Moffitt² proved that the infection known as coccidioidal granuloma was due to a mold (Coccidioides immitis) and were able to grow it on culture mediums. Many reports have appeared since this date.

The similarity of this disease to tuberculosis is noted repeatedly in the literature. This similarity exists in its clinical manifestations and body reactions to the infection. Coccidioidal infections often are miliary and it is impossible without a biopsy or culture of the organism to differentiate them clinically or by roentgenogram from tuberculosis.