Important note: Information in this article was accurate in 1986. The state of the art may have changed since the publication date.
Fungemia due to Coccidioides immitis. An analysis of 16 episodes in 15 patients and a review of the literature.
Medicine (Baltimore). 1986 Sep;65(5):312-21. Unique Identifier : AIDSLINE MED/86310224 Ampel NM; Ryan KJ; Carry PJ; Wieden MA; Schifman RB
Abstract:
Sixteen episodes of fungemia due to Coccidioides immitis were identified in 15 patients over a 7-year period at 2 hospital associated with the University of Arizona in Tucson. Fourteen of the 15 patients were male and 13 had an underlying condition, including malignancy in 6 and AIDS in 3. Ten of the patients were receiving corticosteroids at the time of fungemia. TP antibodies were present in 5 of 9 episodes and some titer of CF antibody was present in 7 of 11 instances. None of the 10 patients tested had a positive 1:100 coccidioidin skin test. In 11 of 15 episodes, a miliary chest roentgenographic pattern was apparent at the time of fungemia. Eleven of the 16 episodes ended in death within 1 month of the positive blood culture. Fungemic patients were compared to patients with culture-proven coccidioidomycosis without fungemia and differed from them significantly in 3 respects. First, fungemic patients were more likely to have a diffuse miliary pattern on chest radiograph. Second, all fungemic patients had, by definition, disseminated coccidioidomycosis and this was more likely among fungemic patients than among non-fungemic patients. Finally, fungemic patients were more likely to die within 1 month of the positive culture for C. immitis. Fungemia occurred in greater than 30% of patients with culture-proven coccidioidomycosis who had a blood culture performed. These results suggest that coccidioidal fungemia is a marker for a severe, acute form of disseminated coccidioidomycosis associated with a high mortality.
Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS Adult Aged Case Report Coccidioides Coccidioidomycosis/COMPLICATIONS/DIAGNOSIS/*MICROBIOLOGY Human Lung/RADIOGRAPHY Male Septicemia/COMPLICATIONS/DIAGNOSIS/*MICROBIOLOGY JOURNAL ARTICLE REVIEW
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Important note: Information in this article was accurate in 1986. The state of the art may have changed since the publication date.
