Coccidioidomycosis in Oklahoma: A retrospective case series.

Autor: Scott B; Department of Medicine, Section of Infectious Diseases, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA., Sassine J; Department of Medicine, Section of Infectious Diseases, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA., Gordon O; Department of Medicine, Section of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA., Agudelo Higuita NI; Department of Medicine, Section of Infectious Diseases, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.; Instituto de Enfermedades Tropicales y Parasitología Antonio Vidal, Tegucigalpa, Honduras.
Jazyk: angličtina
Zdroj: Mycoses [Mycoses] 2024 May; Vol. 67 (5), pp. e13749.
DOI: 10.1111/myc.13749
Abstrakt: Background: Coccidioidomycosis is a systemic fungal disease endemic to arid regions of the Western Hemisphere. In the south-western US, Coccidioides spp. may account for up to 20%-25% of all cases of community acquired pneumonia. Clinical manifestations vary widely, from asymptomatic infection to life-threatening disease, especially in immunocompromised hosts.
Objectives: The primary objective of the study was to characterise cases of coccidioidomycosis in an area of the United States not considered traditionally endemic for the disease.
Methods: We performed a single-centre retrospective study of all cases of coccidioidomycosis from 1 January 2000 to 31 December 2020, in the University of Oklahoma Health Sciences Medical Center.
Results: A total of 26 patients were included for analysis. The central nervous system (CNS) and the lungs were the sites most frequently involved. Twenty (77%) had travelled to a coccidioidomycosis endemic region. Most were male (81%) with a median age of 42 years (range: 3-78 years). The majority (46%) were Caucasians, 19% were African American, 19% Hispanic, and 12% Native American. The most common comorbidities were diabetes mellitus and acquired immunodeficiency syndrome, identified in 27% and 23% of patients, respectively. Patients on immunosuppressive therapy accounted for 12% of all cases.
Conclusion: Our study is one of the largest single-centre case series of coccidioidomycosis from a non-endemic area. Diabetes mellitus was the most frequent comorbidity. Compared to other case series of coccidioidomycosis, our patient population had higher rates of immunosuppression and had both a higher rate of disseminated disease and overall mortality.
(© 2024 Wiley‐VCH GmbH. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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