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Risk factors and outcomes of culture-proven acute Coccidioides spp. infection in San Diego, California, United States.
- Source :
-
Mycoses [Mycoses] 2020 Jun; Vol. 63 (6), pp. 553-557. Date of Electronic Publication: 2020 Apr 01. - Publication Year :
- 2020
-
Abstract
- Background: Coccidioides spp. are dimorphic fungi endemic to parts of the United States, Mexico, Central and South America. Infection can cause a range of disease from self-limited acute pneumonia to severe disseminated disease.<br />Methods: We performed a retrospective chart review of medical records of cases of culture-proven acute coccidioidomycosis at the University of California San Diego between 1 April 2015 and 31 December 2019 and described the demographics, risk factors and outcomes of these cases.<br />Results: Over the study period, fifteen evaluable cases of culture-proven acute coccidioidomycosis were identified. Of these, 87% (13/15) had traditional risk factors for coccidioidomycosis infection while two lacked known risk factors, including one patient with cirrhosis and one with chronic hepatitis C infection. Seven of fifteen (47%) had primary coccidioidomycosis of the lungs without dissemination and 7/15 (47%) disseminated disease. Of those with disseminated disease, 6/7 (86%) had either high-risk ethnicity or blood type as their only risk factor. At 90 days, 11/15 (73%) were alive, 3/15 (20%) deceased and 1/15 (7%) lost to follow-up. Of those not alive at 90 days, 1/3 (33%) had disseminated disease and 2/3 (67%) primary coccidioidomycosis, both on immunosuppressive therapy.<br />Discussion: Coccidioides spp. infection occurs in a variety of hosts with varying underlying risk factors, with the majority in our cohort overall and 86% with disseminated disease lacking traditional risk factors for invasive fungal infection other than ethnicity and/or blood phenotype. Clinicians should be aware of these non-traditional risk factors in patients with coccidioidomycosis infection.<br /> (© 2020 Blackwell Verlag GmbH.)
- Subjects :
- Adult
Aged
California epidemiology
Coccidioides physiology
Coccidioidomycosis physiopathology
Colony Count, Microbial statistics & numerical data
Female
Humans
Lung microbiology
Lung pathology
Male
Medical Records
Middle Aged
Qualitative Research
Retrospective Studies
Risk Factors
Young Adult
Coccidioides isolation & purification
Coccidioidomycosis epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1439-0507
- Volume :
- 63
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Mycoses
- Publication Type :
- Academic Journal
- Accession number :
- 32176829
- Full Text :
- https://doi.org/10.1111/myc.13074