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Coccidioidomycosis in the Acquired Immunodeficiency Syndrome

Authors :
Bruce Porter
Danetta A. Bronnimann
Eskild A. Petersen
John N. Galgiani
Rodney D. Adam
John W. Bloom
Michael P. Habib
Source :
Annals of Internal Medicine. 106:372
Publication Year :
1987
Publisher :
American College of Physicians, 1987.

Abstract

Of 27 patients with the acquired immunodeficiency syndrome (AIDS) in Tucson, Arizona, 7 had concurrent coccidioidomycosis. Early manifestations of infection in 6 patients included diffuse nodular pulmonary infiltrates and Coccidioides immitis in many extrathoracic sites. By comparison, a retrospective review of the cases of 300 patients hospitalized with coccidioidal infection identified only 13 patients without AIDS who had the same extent of infection, and only 3 of these patients had no immunosuppressing conditions. Antibodies for coccidioidal antigens at serum dilutions as high as 1:2048 were detected in 5 of the 7 patients with AIDS. Six had temporary responses to amphotericin B treatment, taken both alone and combined with ketoconazole, but all died within 14 months of their diagnosis of coccidioidomycosis. Because annual rates of coccidioidal infection in the Tucson area are 4% or less, the rate of 27% that we calculated, based on 7 patients having the infection during 26 years of risk for AIDS, suggests frequent reactivation of the infection or enhanced susceptibility to endemic exposure in persons with AIDS.

Details

ISSN :
00034819
Volume :
106
Database :
OpenAIRE
Journal :
Annals of Internal Medicine
Accession number :
edsair.doi.dedup.....4dc0e42f5131d5f77e73be97c15c246b
Full Text :
https://doi.org/10.7326/0003-4819-106-3-372