Coccidioidomycosis of the prostate: a determination of incidence, report of 4 cases, and treatment recommendations

Rare Dysuria: Prostatic Abscess due to Disseminated Coccidioidomycosis

“…Infection with C. immitis results in symptomatic pulmonary disease in fewer than half of those infected, and dissemination beyond the lungs occurs in less than 1% of patients 4, 5, 6, 7. At increased risk for disseminated infection are the immunosuppressed, pregnant women, diabetics, and non-Caucasians 4 .…”

“…At increased risk for disseminated infection are the immunosuppressed, pregnant women, diabetics, and non-Caucasians 4 . Filipinos have repeatedly been identified as especially susceptible 5, 6. The most common sites of involvement in dissemination are the joints, skin, bones, and meninges 5 .…”

“…Filipinos have repeatedly been identified as especially susceptible 5, 6. The most common sites of involvement in dissemination are the joints, skin, bones, and meninges 5 . Already rare, urogenital tract involvement most commonly involves the kidneys 4 …”

“…A review of the literature reveals fewer than 40 case of male non-renal genitourinary tract involvement described since 1943, and fewer than fifteen cases of prostatic involvement 4, 5, 7. However, a retrospective review of 3676 prostatic pathology reports (biopsies and surgical pathology) from two Arizona hospitals (an area of endemic C. immitis ) found that 44 cases of granulomatous Coccidioides of the prostate gland were identified (an incidence of 1.2%), suggesting that the undiagnosed rate may be higher in endemic areas 8 …”

Atypical infections of the prostate

“…The remaining two patients received no antifungal therapy and were observed. The study concluded that patients with minimal tissue violation can be observed whereas patients with more extensive tissue violation should receive antifungal therapy [30].…”