Primary Coccidioidal Pleural Effusions Successfully Treated with Adjunctive Corticosteroid Therapy

Introduction: There is limited data suggesting that recovery from severe pulmonary infection with Coccidioides may be hastened by the addition of systemic corticosteroids. Methods/Results: We report two patients with persistent and progressive coccidioidomycosis who demonstrated a dramatic response to adjunctive corticosteroid therapy. Both patients had Coccidioides immiitis cultured from respiratory samples. One was a 69 year old man who had been treated with combination fluconazole and liposomal amphotericin for over six weeks, with persistent fever and pneumonia. The other was a 61 year old man treated with fluconazole and then amphotericin for three weeks, with progression to acute respiratory distress syndrome (ARDS) and shock. Both received short courses of intravenous methylprednisolone and recovered to be discharged home. Conclusion: As opposed to associated hypersensitivity, corticosteroid treatment in these cases was directed at modulating the ongoing destructive effects of unchecked inflammation. Rapid improvement was noted in both cases and raises the possibility that the addition of systemic corticosteroids may hasten recovery in patients with severe coccidioidomycosis.

show abstract

Corticosteroids in the Management of Severe Coccidioidomycosis

Chang

Chopra

Beenhouwer

et al. 2019

The American Journal of Medicine

View full text Add to dashboard Cite

show abstract

Treatment considerations in pulmonary coccidioidomycosis

Hartmann

Aye

Blair

2016

Expert Review of Respiratory Medicine

View full text Add to dashboard Cite

This review discusses current literature regarding medical treatment options, including the various triazoles and amphotericin B products. In addition, we discuss uncomplicated and complicated pulmonary infections and their sequelae and the approach to managing coccidioidomycosis in certain populations of patients, such as pregnant women, transplant recipients, individuals infected with human immunodeficiency virus, and recipients of tumor necrosis factor-α inhibitors. Expert commentary: Symptomatic coccidioidomycosis can present physicians with a number of challenges, including the lack of sensitivity and specificity of diagnostic tests and lack of a standard treatment approach for all patients with the infection. Ongoing and future clinical trials will determine the optimal diagnostic, therapeutic, and prophylactic approaches, particularly for patients with comorbid conditions.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Primary Coccidioidal Pleural Effusions Successfully Treated with Adjunctive Corticosteroid Therapy

Cited by 2 publications

References 9 publications

Corticosteroids in the Management of Severe Coccidioidomycosis

Corticosteroids in the Management of Severe Coccidioidomycosis

Treatment considerations in pulmonary coccidioidomycosis

Contact Info

Product

Resources

About