Criteria included 1) clinical presentation with influenza-like signs and symptoms, pneumonia, meningitis, or involvement of bones, joints, or skin; and 2) laboratory confirmation with cultural, histopathologic, or molecular evidence of Coccidioides, or positive serologic test results for coccidioidal
IgM (by immunodiffusion, enzyme immunoassay [EIA], latex agglutination, or tube precipitin) or for coccidioidal
IgG (by immunodiffusion, EIA or complement fixation).
The incidence of coccidioidal
infection is highest in late summer and early fall.
This results in chronic symptomatic fungal lung disease (eg, chronic pulmonary histoplasmosis, chronic blastomycosis, persistent coccidioidal
7) After resolution of primary coccidioidal
pneumonia, an asymptomatic nodule or thin-walled cavity is not uncommon and this gradually resolves.
The concurrent use of fluconazole (despite the relatively low dose) would be expected to reduce, to some degree, the risk of cryptococcal and coccidioidal
disease in this instance.
The recently available coccidioidal
spherulin skin test may also be a potentially useful tool for identifying at-risk employees.
A 1991 study of 10 pregnant subjects showed a decreased response to spherulin antigen in patients who had demonstrated prepartum coccidioidal
immunity and little-to-no response in patients with active infection.
Abstract: Rupture of a coccidioidal
pulmonary cavity with subsequent pyopneumothorax is a rare clinical event, even in areas endemic for coccidioidomycosis.
Fluconazole therapy for coccidioidal
meningitis: The NIAID-Mycoses Study Group.
In Arizona, Maricopa County has been the center of a coccidioidal
epidemic for years (1).
infection from pneumonia caused by viruses or bacteria is difficult.
For all hospitalizations, the most common types of coccidioidomycosis diagnoses were for primary pulmonary (48%), other forms of progressive (18%), and coccidioidal
meningitis (13%) (Table 1).