Hospitalizations associated with disseminated coccidioidomycosis
, Arizona and California, USA.
The differentiation between a primary cutaneous coccidioidomycosis and a disseminated one without obvious pulmonary symptoms might be difficult, given the fact that their histology is the same and disseminated coccidioidomycosis
may present a phenomenon called locus minoris resistentiae, where the organisms of the bloodstream have a predilection for lodging in areas with previous trauma (lacerations or punctures).
Combination therapy of disseminated coccidioidomycosis
with caspofungin and fluconazole.
A few patients develop disseminated coccidioidomycosis
, which is associated with high morbidity and mortality.
The HLA class II-DRB1*1301 allele has been identified as a possible immunologic factor for severe disseminated coccidioidomycosis
, regardless of the patient's race.
This is an important consideration because high rates among Asians and blacks have been documented previously, and black race has been shown to be an independent risk factor for disseminated coccidioidomycosis
A 27-year-old gravida 3, para 2 pregnant woman was hospitalized at our institution at 26 weeks for disseminated coccidioidomycosis
including diffuse pulmonary infiltrates and a lytic bone lesion in her iliac crest.
Initially, the differential diagnosis for this patient included typical mycobacterial infection, disseminated blastomy cosis, cryptococcosis, and disseminated coccidioidomycosis
Severe or disseminated coccidioidomycosis
requires treatment and can be fatal.
An autopsy showed disseminated coccidioidomycosis
involving his lungs, lymph nodes, liver, spleen, kidneys and omentum (Figure 5.
In addition, blacks and persons of Filipino ancestry have been found to have increased risk for disseminated coccidioidomycosis
, possibly because of underlying differences in susceptible host genetics (1,10).