Small bowel dissemination of XXXX .

@entity1 @entity390 @entity1353 @entity843 @entity1661 @entity344 @entity490 @entity8662 @entity6656 @entity158
@entity344 is extremely rare, with less than 10 cases reported in the literature. We report a case of small bowel dissemination of @entity6656 in a 21-year-old African American male with a history of living in San Joaquin Valley. The @entity1 presented with one week of @entity490 , @entity390 , @entity1353 , intermittent fever, and sweat, and one month of @entity1661 . A chest radiograph revealed complete effusion of left lung. A computed tomography scan of the abdomen showed diffuse small bowel thickening and enhancement, as well as omental and peritoneal nodules, and @entity843 . The coccidioidal complement fixation titer was 1   :   256. The duodenal biopsy revealed many spherules filled with round fungal endospores. Later, blood fungal culture showed positivity for @entity8662 . The final diagnosis is disseminated @entity6656 involving lungs, blood, and duodenum. Despite aggressive antifungal therapy, the @entity1 's clinical situation deteriorated and he succumbed to multisystem organ failure one and half months later. A high index of suspicion for @entity344 should be maintained in @entity1 from an endemic area presenting as @entity1661 and @entity158 .
