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
...iagnosis
...e 2. Areas Endemic for Coccidioidomycosis...
...as within endemic regions of Arizona...
...ination Hematogenous spread beyon...
...erological Testing Enzyme immunoassay...
...stopathology An alternative approach to diagn...
...aluation at the Time of Initial Di...
...3. Coccidioidal Pneumo...
Treatment
...eatment...
...Coccidioidomycosis in Patients Withou...
...n and Physical Therapy Reconditioning Program...
...uncomplicated pulmonary coccidioidomyco...
...mmends patient education, close observation,...
...ntifungal Drug Therapy In Patients With...
...commends initiating antifungal tre...
...nts at the time of diagnosis with extensive...
...treatment is begun in nonpregnant ad...
...onary Coccidioidomycosis With an Asymptomat...
Once there is confirmation that a pulmonary no...
...Coccidioidal Cavity Without an Immunosuppressing...
...ends against the use of antifungal t...
...matic Chronic Cavitary Coccidioidal Pneu...
...e IDSA recommends that patients with sympt...
...DSA recommends that surgical options be explored...
...nds that when surgical management o...
...ients with ruptured coccidioidal cavit...
...f the pleural space is massively cont...
...ts with ruptured coccidioidal cavit...
...ary Soft Tissue Coccidioidomycosis, Not Associat...
...ommends antifungal therapy in all ca...
...he IDSA recommends oral azoles, in part...
...mends intravenous AmB in cases of azole fai...
...d/or Joint Coccidioidomycosis...
...mends azole therapy for bone and joint...
...severe osseous disease, the IDSA recommends...
The IDSA recommends surgical consultat...
...rocedures are recommended in addition to antifu...
...IDSA recommends that surgical consultati...
...ewly Diagnosed Coccidioidal Infec...
...recently diagnosed coccidioidal infection, the...
...occidioidal meningitis (CM), the IDSA...
...SA recommends azole treatment for life. ( S , M...
...with CM who clinically fail initial...
...s with increased intracranial pressure (I...
...most patients who develop ICP will not resolv...
...nds that patients with ventriculoperitoneal s...
...hunt has developed a bacterial or other...
In patients with CM who initially r...
...ement of Patients With Coccidioidomycosis in S...
...or the treatment of autologous or a...
...treatment of patients with very severe and/or ra...
...tologous or allogeneic HSCT or solid org...
...llogeneic HSCT or solid organ transplant r...
...ing initial treatment of active coccidioidom...
...ends oral azole therapy for recipie...
...ith Coccidioidomycosis and Their Neonat...
...g Pregnancy...
...opment of symptomatic coccidioidomycos...
For women who develop initial nonmeningeal cocc...
Other options include no therapy with clo...
...zole antifungal after educating the mother r...
...er the first trimester of pregnancy, an azole a...
...native would be to administer intravenous A...
...r women who develop CM during the fir...
...the first trimester and in cases where disease...
...a history of prior uncomplicated cocc...
...h women, close follow-up, including obtaining co...
...men with nonmeningeal coccidioidomycosis on...
...rnative to this, especially if the coccidioidal...
...t woman with CM who is on azole antifungal the...
...eriod, one approach is to initiate intrathec...
...tifungal therapy may then be restarte...
...AmB continued throughout gestation...
...ernative is to continue azole anti...
...al alternative for the pregnant woman wit...
...pment of a febrile pulmonary illness duri...
...r Neonates...
...commends against coccidioidal serologic tests for...
...iric therapy with fluconazole at 6–12 mg/kg dail...
...tfeeding is NOT recommended for mo...
HIV Co-Infection
...Co-Infection
...prophylaxis is NOT recommended to pr...
...herapy is recommended for all patients...
...therapy should be continued as long as t...
For patients with peripheral CD4 T-lym...
...dal-endemic regions, patients shou...
...de coccidioidal-endemic regions, serolo...
...lthough data are lacking, pediatric patient...
...potent antiretroviral therapy (ART) should no...
...trategies for Coccidioidomycosis in Special At-R...
...all patients undergoing organ transplantation...
...the endemic area, the IDSA recommends scre...
...DSA does NOT recommend regular serologic screen...
Table 1. Recommended Drugs
...Recommended DrugsHaving trouble viewin...