Coccidioidomycosis

Galgiani, John N.; Ampel, Neil M.; Blair, Janis E.; Catanzaro, Antonino; Johnson, Royce H.; Stevens, David A.; Williams, Pamela R. D.

doi:10.1086/496991

Cited by 591 publications

(458 citation statements)

References 40 publications

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“…In addition, due to possible drug interactions, plasmatic levels of calcineurinic inhibitor drugs should be monitored during itraconazole use. The duration of this prophylaxis is difficult to establish, but a course of at least 3 to 6 months, covering the period of more active immunosuppression, should be offered (127). Early experience with the use of posaconazole in the treatment of histoplasmosis has been favorable, but further studies are necessary to assess its use in prophylaxis (309).…”

Section: Infections Caused By Histoplasma Capsulatummentioning

confidence: 99%

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

et al. 2008

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SUMMARY In recent years, the increasing number of donors from different regions of the world is providing a new challenge for the management and selection of suitable donors. This is a worldwide problem in most countries with transplantation programs, especially due to the increase in immigration and international travel. This paper elaborates recommendations regarding the selection criteria for donors from foreign countries who could potentially transmit tropical or geographically restricted infections to solid-organ transplant recipients. For this purpose, an extensive review of the medical literature focusing on viral, fungal, and parasitic infections that could be transmitted during transplantation from donors who have lived or traveled in countries where these infections are endemic has been performed, with special emphasis on tropical and imported infections. The review also includes cases described in the literature as well as risks of transmission during transplantation, microbiological tests available, and recommendations for each infection. A table listing different infectious agents with their geographic distributions and specific recommendations is included.

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Section: Infections Caused By Histoplasma Capsulatummentioning

confidence: 99%

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

et al. 2008

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“…Similarly, caspofungin was shown efficacious in treating a disseminated coccidioidomycosis infection in a renal transplant recipient intolerant to standard therapy (Antony, 2004). This Pulmonary blastomycosis and caspofungin evidence alone was sufficient to consider caspofungin of possible benefit in coccidioidomycosis guidelines (Galgiani et al, 2005). It is unclear whether the same inference can be made about caspofungin for blastomycosis.…”

Section: Discussionmentioning

confidence: 90%

Treatment of chronic pulmonary blastomycosis with caspofungin

Mardini

Nguyen

Ghannoum³

et al. 2011

Journal of Medical Microbiology

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Current practice guidelines recommend that pulmonary blastomycosis be treated with antifungal agents such as amphotericin B and itraconazole. Echinocandins are not recommended because of poor in vitro activity against Blastomyces dermatitidis and lack of supporting clinical data. We report a case of chronic pulmonary blastomycosis treated successfully with caspofungin. Case reportA 32-year-old male with no prior history of disease and working in construction presented with an insidious onset of right thoracic pain in November 2008. He was living in proximity of the St. Lawrence River, and had recently been exposed to a flooded soil environment. He did not take any medication and had a 42 pack-years smoking history. His chest pain was later followed by haemoptysis and exacerbation of a chronic cough. The patient denied any dyspnoea or expectorations and did not report any constitutional symptoms except for occasional nocturnal diaphoresis. The systems inquiry and physical examination were otherwise unremarkable.Laboratory testing revealed a white blood cell count of 11.2610 9 cells l 21 and an erythrocyte sedimentation rate slightly elevated at 24 mm h 21 . Biochemistry results were in the normal range. A chest X-ray on admission showed discrete opacities in the right paratracheal area. HIV, p-ANCA and c-ANCA testing were negative. In December 2008, a thoracic computed tomography (CT) scan demonstrated a right upper lobe parenchymal consolidation of 47661 mm with occlusion of the left superior lobe bronchus. Bronchocentric nodular opacities and infracentimetric mediastinal lymph nodes were also visualized (Fig. 1a). Bronchoscopy confirmed the presence of an obstructive polypoid mass in the left superior bronchus. An endobronchial biopsy revealed non-necrotizing granulomatous inflammation with several multinucleated giant cells without micro-organisms, neoplasm or vasculitis.In February 2009, further investigation was undertaken because the pulmonary mass had remained identical on control CT scan. A transthoracic needle biopsy demonstrated a fibroinflammatory reaction with multinucleated giant cells and a suppurative infiltrate containing a few 10 mm spherical micro-organisms with a thick wall and broad-based budding consistent with Blastomyces dermatitidis (Fig. 2). Despite negative cultures, histopathology was sufficient to confirm definite diagnosis of blastomycosis (De Pauw et al., 2008).In March 2009, the working diagnosis was chronic pulmonary blastomycosis in an immunocompetent host without evidence of dissemination. Because of the absence of spontaneous resolution at least 3 months after presentation, we decided to initiate antifungal therapy. The patient first received amphotericin B deoxycholate (Fungizone; BristolMyers Squibb) for 4 days but developed acute renal failure (serum creatinine rapidly increased from 70 to 225 mmol l 21 ). Treatment was switched to liposomal amphotericin B (AmBisome; Astellas Pharma) for 5 days with no improvement of renal function. The total administered cumulative dose of ...

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“…Because most patients with primary coccidioidal pneumonia have spontaneous resolution of signs and symptoms, a patient with undiagnosed coccidioidomycosis who receives antibacterial therapy may appear to respond to treatment. However, a substantial portion of patients with coccidioidal pneumonia may have a protracted course and may benefi t from specifi c antifungal treatment (6). Two of the authors (J.E.B.…”

Section: Discussionmentioning

confidence: 99%

Coccidioidal Pneumonia, Phoenix, Arizona, USA, 2000–2004

Kim

Blair²,

Carey³

et al. 2009

Emerg. Infect. Dis.

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Community-acquired pneumonia (CAP) often results in severe illness and death. In large, geographically defi ned areas where Coccidioides spp. are endemic, coccidioidomycosis is a recognized cause of CAP, but its frequency has not been studied extensively. To determine the frequency of patients with coccidioidomycosis, we conducted a prospective evaluation of 59 patients with CAP in the Phoenix, Arizona, area. Of 35 for whom paired coccidioidal serologic testing was performed, 6 (17%) had evidence of acute coccidioidomycosis. Coccidioidal pneumonia was more likely than noncoccidioidal CAP to produce rash. The following were not found to be risk factors or reliable predictors of infection: demographic features, underlying medical conditions, duration of time spent in disease-endemic areas, occupational and recreational activities, initial laboratory studies, and chest radiography fi ndings. Coccidioidomycosis is a common cause of CAP in our patient population. In the absence of distinguishing clinical features, coccidioidal pneumonia can be identifi ed only with appropriate laboratory studies.

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Coccidioidomycosis

Cited by 591 publications

References 40 publications

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

Treatment of chronic pulmonary blastomycosis with caspofungin

Coccidioidal Pneumonia, Phoenix, Arizona, USA, 2000–2004

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