Surgery for Pulmonary Coccidioidomycosis: A 10-Year Experience

Jaroszewski, Dawn E.; Halabi, Wissam J.; Blair, Janis E.; Coakley, Brandon J.; Wong, Raymond Chi-Wing; Parish, James M.; Vaszar, Laszlo T.; Kusne, Shimon; Vikram, Holenarasipur R.; DeValeria, Paterick A.; Lanza, Louis A.; Arabía, Francisco A.

doi:10.1016/j.athoracsur.2009.07.075

Cited by 44 publications

(34 citation statements)

References 26 publications

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“…Jaroszewski and colleagues recently reviewed surgical cases at a single center in the area of endemicity from 1998 to 2008 (165). Of 1,496 patients diagnosed with coccidioidomycosis during this period, 86 (6%) underwent surgery.…”

Section: Complicated Pulmonary Coccidioidomycosismentioning

confidence: 99%

Recent Advances in Our Understanding of the Environmental, Epidemiological, Immunological, and Clinical Dimensions of Coccidioidomycosis

et al. 2013

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SUMMARY Coccidioidomycosis is the endemic mycosis caused by the fungal pathogens Coccidioides immitis and C. posadasii . This review is a summary of the recent advances that have been made in the understanding of this pathogen, including its mycology, genetics, and niche in the environment. Updates on the epidemiology of the organism emphasize that it is a continuing, significant problem in areas of endemicity. For a variety of reasons, the number of reported coccidioidal infections has increased dramatically over the past decade. While continual improvements in the fields of organ transplantation and management of autoimmune disorders and patients with HIV have led to dilemmas with concurrent infection with coccidioidomycosis, they have also led to advances in the understanding of the human immune response to infection. There have been some advances in therapeutics with the increased use of newer azoles. Lastly, there is an overview of the ongoing search for a preventative vaccine.

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Section: Complicated Pulmonary Coccidioidomycosismentioning

confidence: 99%

Recent Advances in Our Understanding of the Environmental, Epidemiological, Immunological, and Clinical Dimensions of Coccidioidomycosis

et al. 2013

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“…Patients with CF may have a higher rate of false-positive coccidioidal IgM serology, which further complicates the diagnosis (24). Likewise, coccidioidal serology can be negative in up to 62% of patients with biopsy-proven coccidioidal pulmonary nodules (25). Coexisting illnesses or multiorgan involvement from CF (e.g., cirrhosis of the liver, diabetes mellitus, and renal failure) can lead to altered host defenses and cell-mediated immune defects resulting in a higher propensity for refractory or disseminated coccidioidomycosis (26 -28).…”

Section: Coccidioidomycosis In Potential Transplant Candidatesmentioning

confidence: 99%

Coccidioidomycosis and Lung Transplantation

2011

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Coccidioidomycosis, an endemic fungal infection in the desert southwestern United States, causes substantial morbidity and mortality in immunocompromised hosts. Because lungs are the primary site of coccidioidal infection, lung transplant recipients in endemic areas remain particularly vulnerable. Moreover, direct airway communication to the environment, diminished cough reflex, impaired mucociliary clearance, altered alveolar macrophage function, and ischemic lung injury further enhances the risk of pulmonary infection after lung transplantation. Herein, we review available data on coccidioidomycosis in solid organ transplant recipients and candidates seeking transplantation, and propose strategies for screening, treatment, and prevention of coccidioidal infection in the lung transplant candidate.

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“…The optimal timing, duration, type, and necessity of adjuvant antifungal pharmacotherapy in this high-risk group of surgical patients remains unknown [1,2]. As with other patient groups exhibiting significant pulmonary involvement with fungi such as Coccidioidomycosis, administration of antifungal chemotherapy has been variable and inconsistent [3]. As surgeons, we are left without good scientific data on what is really the optimal therapeutic drug, dosing, and duration of treatment.…”

Section: Invited Commentarymentioning

confidence: 99%