Background: Coccidioidomycosis is caused by a fungus endemic to the soil in the southwestern United States, Mexico, Central, and South America. While many exposed people never have symptoms, about 1% of patients can develop systemic, disseminated infection, most commonly in the lungs. Case presentation: We describe an unusual case of tubo-ovarian abscesses secondary to disseminated coccidioidomycosis. Conclusion: While unusual, coccidioidomycosis should be considered in the differential diagnosis of tubo-ovarian abscesses not responding to antibiotics. The diagnosis of coccidiomycosis as an infectious etiology of a tubo-ovarian abscess will allow the tailoring of the appropriate medical treatment, and potentially avoiding unnecessary surgery. Teaching points: Consider coccidioidomycosis as a rare but possible source of persistent tubo-ovarian abscess in a patient unresponsive to antibiotics.
Yang S and Sit A