Coccidioidomycosis
Key Points
Key Points
Residence in and recent travel to these areas are critical elements for the accurate recognition of patients who develop this infection.
The most common syndrome to come to medical attention is a community-acquired pneumonia (CAP), often associated with a variety of rheumatologic, cutaneous, or systemic complaints.
Differences in disease severity are thought to be predominantly the consequence of differences in the immunologic responses to infection among individuals.
Figure 1. Estimated Numbers of Annual Infections in the United States and their Clinical Manifestations
Diagnosis
...agnosis
...s Endemic for Coccidioidomycosis...
...ithin endemic regions of Arizona hav...
...ssemination Hematogenous spread...
...l Testing Enzyme immunoassays (EIAs...
...Histopathology An alternative a...
...aluation at the Time of Initial Dia...
Figure 3. Coccidioidal P...
Treatment
...eatment
...agement of Coccidioidomycosis in Patients Wi...
...tion and Physical Therapy Recondition...
...nts with uncomplicated pulmonary coccidioidomyc...
...nds patient education, close observation, and sup...
...g Antifungal Drug Therapy In Patients With Newly...
...nds initiating antifungal treatment for patients...
...tients at the time of diagnosis with extensive pul...
...s begun in nonpregnant adults, the tre...
...idioidomycosis With an Asymptomatic Pulmonary...
...s confirmation that a pulmonary nodule is due to...
...ptomatic Coccidioidal Cavity Without an Imm...
...nds against the use of antifungal therapy for...
...ymptomatic Chronic Cavitary Coccidioidal Pneumo...
...DSA recommends that patients with symptomati...
...he IDSA recommends that surgical option...
...recommends that when surgical mana...
...patients with ruptured coccidioidal cavity, t...
...e pleural space is massively contaminated...
For patients with ruptured coccidio...
...ulmonary Soft Tissue Coccidioidomycosis, N...
...commends antifungal therapy in all cases of ext...
...SA recommends oral azoles, in particu...
...recommends intravenous AmB in cases of azole fa...
...e and/or Joint Coccidioido...
...IDSA recommends azole therapy for bon...
...e osseous disease, the IDSA recommends AmB a...
...recommends surgical consultation for all pat...
...procedures are recommended in addition to...
...A recommends that surgical consultation be ob...
...sed Coccidioidal Infection...
...ients with recently diagnosed coccidioidal infect...
For coccidioidal meningitis (CM), the IDSA recomme...
For CM, the IDSA recommends azole trea...
...tients with CM who clinically fail initial th...
...s with increased intracranial pressure (ICP) at t...
Because most patients who develop ICP...
...nds that patients with ventriculoperit...
...shunt has developed a bacterial or o...
...with CM who initially respond to a treat...
...anagement of Patients With Coccidioidomycosi...
...ment of autologous or allogeneic hematopoietic st...
...e treatment of patients with very seve...
...logous or allogeneic HSCT or solid organ tra...
...allogeneic HSCT or solid organ tra...
...itial treatment of active coccidioidomyco...
...DSA recommends oral azole therapy for recip...
...omen With Coccidioidomycosis and Their Neonate...
...g Pregnancy...
...he development of symptomatic coccidioidomycosis...
...men who develop initial nonmeningeal coccid...
...nclude no therapy with close monitoring, ( W , L)...
...an azole antifungal after educatin...
...st trimester of pregnancy, an azole ant...
...alternative would be to administer intraven...
...evelop CM during the first trimest...
...first trimester and in cases where disease is...
...women with a history of prior uncomplicate...
...h women, close follow-up, including obtainin...
...nonmeningeal coccidioidomycosis on anti...
...e to this, especially if the coccid...
...pregnant woman with CM who is on azole antifun...
...g this period, one approach is to initia...
...antifungal therapy may then be restarted...
...cal AmB continued throughout gestation. ( W , L)...
...ernative is to continue azole antifungal ther...
...nal alternative for the pregnant woma...
...ment of a febrile pulmonary illness during preg...
...Neonates...
...he IDSA recommends against coccidio...
...ric therapy with fluconazole at 6...
...ng is NOT recommended for mothers o...
HIV Co-Infection
HIV Co-Infection
...tifungal prophylaxis is NOT recommended to prev...
...therapy is recommended for all patie...
...ifungal therapy should be continued as...
...ients with peripheral CD4 T-lympho...
...ithin coccidioidal-endemic regions, patients shou...
...utside coccidioidal-endemic regions, serologi...
...ough data are lacking, pediatric pati...
...otent antiretroviral therapy (ART) should...
...tive Strategies for Coccidioidomycosis in Specia...
...patients undergoing organ transpla...
...in the endemic area, the IDSA recommends...
...oes NOT recommend regular serologic screen...
Table 1. Recommended Drugs
...commended DrugsHaving trouble viewing tab...