Coccidioidomycosis: Recent Updates

Twarog, Meryl; Thompson, George R.

doi:10.1055/s-0035-1562900

Cited by 53 publications

(48 citation statements)

References 67 publications

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“…Thus, occupational and recreational activities that contribute to soil and environmental disruption are a primary risk factor for infection by dimorphic fungal pathogens. [39][40][41][42] Most infection outbreaks can be traced back to specific events that led to conidia release from soils and their subsequent inhalation. 34,35,[43][44][45][46][47] Therefore, practices to avoid or reduce the potential for aerosolization and inhalation of conidia are prescribed for high risk areas 34,41,48,49 Within the lungs, conidia transition into pathogenicphase cells which survive innate immune defenses.…”

Section: Dimorphic Fungal Pathogen Disease and Treatmentmentioning

confidence: 99%

Antifungal therapeutics for dimorphic fungal pathogens

Goughenour

Rappleye

2016

Virulence

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Dimorphic fungi cause several endemic mycoses which range from subclinical respiratory infections to life-threatening systemic disease. Pathogenic-phase cells of Histoplasma, Blastomyces, Paracoccidioides and Coccidioides escape elimination by the innate immune response with control ultimately requiring activation of cell-mediated immunity. Clinical management of disease relies primarily on antifungal compounds; however, dimorphic fungal pathogens create a number of challenges for antifungal drug therapy. In addition to the drug toxicity issues known for current antifungals, barriers to efficient drug treatment of dimorphic fungal infections include natural resistance to the echinocandins, residence of fungal cells within immune cells, the requirement for systemic delivery of drugs, prolonged treatment times, potential for latent infections, and lack of optimized standardized methodology for in vitro testing of drug susceptibilities. This review will highlight recent advances, current therapeutic options, and new compounds on the horizon for treating infections by dimorphic fungal pathogens.

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Section: Dimorphic Fungal Pathogen Disease and Treatmentmentioning

confidence: 99%

Antifungal therapeutics for dimorphic fungal pathogens

Goughenour

Rappleye

2016

Virulence

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“…Of those who become symptomatic, 60% have had a respiratory infection, usually pneumonia or bronchitis [8]. Most cases resolve spontaneously.…”

Section: Discussionmentioning

confidence: 99%

“…Most cases resolve spontaneously. Only 3–5% of patients develop chronic respiratory infection [8]. Almost all the morbidity and mortality associated with coccidioidomycosis is due to the chronic manifestations rather than to the acute respiratory infections [8].…”

Section: Discussionmentioning

confidence: 99%

A Case of Osteomyelitis of the toe caused by Coccidioidomycosis in a 17 year-old with Diabetes Insipidus

Khalid

Boken

Nelson

et al. 2017

IDCases

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We report a case of a 17-year-old male who presented with pain in his right first toe. His pain and swelling had worsened and x-rays of his foot revealed erosive changes of the great toe distal phalanx suggesting possible osteomyelitis. His co-morbidities were morbid obesity and diabetes insipidus. He was admitted to the hospital, blood cultures were drawn, and he was started on vancomycin for presumed bacterial osteomyelitis. He underwent incision and drainage of the fluctuant abscess of the toe, where a culture of the wound was taken. Preliminary results grew fungi. Being located in an endemic area, he was started on anti-fungal treatment for presumed disseminated coccidioidomycosis; culture was positive for Coccidiodes immitis. He also had serology positive for coccidioidomycosis titers. He had uneventful hospital stay and was discharged on long-term oral antifungal therapy.

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“…Coccidioidal meningitis (CM) is a rare but deadly complication of coccidioidomycosis and has a documented mortality if untreated of 90% in 1 year and 100% in 2 years [90,91,92]. The diagnosis of CM is an ongoing challenge in clinical practice owing to its infrequency, non-specific presenting symptoms, and/or a delay in the positivity of a CSF culture or antibody [93,94,95].…”

Section: Bdg In Cerebrospinal Fluid (Csf)mentioning

confidence: 99%

Translational Development and Application of (1→3)-β-d-Glucan for Diagnosis and Therapeutic Monitoring of Invasive Mycoses

McCarthy

Petraitienė

Walsh

2017

IJMS

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Early diagnosis and prompt initiation of appropriate antimicrobial therapy are crucial steps in the management of patients with invasive fungal infections. However, the diagnosis of invasive mycoses remains a major challenge in clinical practice, because presenting symptoms may be subtle and non-invasive diagnostic assays often lack sensitivity and specificity. Diagnosis is often expressed on a scale of probability (proven, probable and possible) based on a constellation of imaging findings, microbiological tools and histopathology, as there is no stand-alone assay for diagnosis. Recent data suggest that the carbohydrate biomarker (1→3)-β-d-glucan may be useful in both the diagnosis and therapeutic monitoring of invasive fungal infections due to some yeasts, molds, and dimorphic fungi. In this paper, we review recent advances in the use of (1→3)-β-d-glucan to monitor clinical response to antifungal therapy and explore how this assay may be used in the future.

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Coccidioidomycosis: Recent Updates

Cited by 53 publications

References 67 publications

Antifungal therapeutics for dimorphic fungal pathogens

Antifungal therapeutics for dimorphic fungal pathogens

A Case of Osteomyelitis of the toe caused by Coccidioidomycosis in a 17 year-old with Diabetes Insipidus

Translational Development and Application of (1→3)-β-d-Glucan for Diagnosis and Therapeutic Monitoring of Invasive Mycoses

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