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Viale MN, López-Joffre MC, Motter AN, Mansilla PE, Vivot FG, Muise Acevedo FM, David VDV, Carrizo SG, Serrano J, Chacón Y, Miranda PC, Alvarez C, Colombres MS, Riera F, Dávalos F, Fernández N, Fernández A, Posse G, Fraenza L, Giordano A, Ampuero A, Amigot S, Guelfand L, Formosa P, Machain M, Saavedra R, Giusiano G, Toranzo AI, Canteros CE. Epidemiology of coccidioidomycosis in Argentina, an update. Med Mycol 2024; 62:myae024. [PMID: 38479781 DOI: 10.1093/mmy/myae024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/26/2024] [Accepted: 03/12/2024] [Indexed: 05/08/2024] Open
Abstract
The National Reference Laboratory in Clinical Mycology of Argentina conducted a retrospective review of human coccidioidomycosis cases diagnosed by the National Mycology Laboratory Network of Argentina between 2010 and 2022 to determine the burden of the disease in the country. A total of 100 human coccidioidomycosis cases were documented, with a higher prevalence in male patients (male-to-female ratio of 1.9:1), with a median age of 41 years. Comparing the number of cases between two 10-year periods (2000-2009 and 2010-2019), the increase was 36.51% (from 63 to 86 cases). Among the 100 recorded cases, 79 tested positive using the double immunodiffusion test. Spherules were observed in 19 cases through histopathology or direct microscopic examination and the fungus was isolated in 39 cases. Thirty-six isolates were identified as Coccidioides posadasii through partial sequencing of the Ag2/PRA gene. Catamarca province had the highest number of cases, comprising 64% of the total, with an incidence rate above 1.0-2.5/100,000 inhabitants until 2018. However, there has been a recent downward trend in the region from 2018 to 2022. It is concerning that more than half of diagnosed cases were chronic pulmonary or disseminated forms, indicating a lack of early disease detection. To rectify this issue, it is imperative to conduct targeted training programs for healthcare personnel and enhance public awareness within the endemic area. This will contribute to a better understanding of the true burden of coccidioidomycosis and enable the implementation of appropriate sanitary control measures.
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Affiliation(s)
- Mariana Noelia Viale
- Departamento Micología, Laboratorio Nacional de Referencia en Micología Clínica, Instituto Nacional de Enfermedades Infecciosas, ANLIS "Dr. Carlos G. Malbrán", Argentina
| | - María Cecilia López-Joffre
- Departamento Micología, Laboratorio Nacional de Referencia en Micología Clínica, Instituto Nacional de Enfermedades Infecciosas, ANLIS "Dr. Carlos G. Malbrán", Argentina
| | - Andrea Nora Motter
- Unidad Operativa Centro de Contención Biológica, ANLIS "Dr. Carlos G. Malbrán", Argentina
| | | | - Flavia Gisele Vivot
- Departamento Micología, Laboratorio Nacional de Referencia en Micología Clínica, Instituto Nacional de Enfermedades Infecciosas, ANLIS "Dr. Carlos G. Malbrán", Argentina
| | - Facundo Manuel Muise Acevedo
- Departamento Micología, Laboratorio Nacional de Referencia en Micología Clínica, Instituto Nacional de Enfermedades Infecciosas, ANLIS "Dr. Carlos G. Malbrán", Argentina
| | | | | | - Julián Serrano
- Laboratorio de Micología, Hospital Independencia, Argentina
| | | | | | | | | | | | | | - Norma Fernández
- Sección Micología-División Infectología, Hospital de Clínicas José de San Martín, Argentina
| | | | - Gladys Posse
- Hospital Nacional Profesor Alejandro Posadas, Argentina
| | - Laura Fraenza
- Hospital Nacional de Clínicas, Facultad de Ciencias Médicas de Córdoba, Argentina
| | | | | | - Susana Amigot
- Centro De Especialidades Médicas Ambulatorias Rosario, Argentina
| | | | | | - Mónica Machain
- Hospital Interzonal de Agudos Dr. Abraham Piñeyro, Argentina
| | | | - Gustavo Giusiano
- Instituto de Medicina Regional-Departamento Micología-CONICET, Universidad Nacional del Nordeste, Argentina
| | - Adriana Inés Toranzo
- Departamento Micología, Laboratorio Nacional de Referencia en Micología Clínica, Instituto Nacional de Enfermedades Infecciosas, ANLIS "Dr. Carlos G. Malbrán", Argentina
| | - Cristina Elena Canteros
- Departamento Micología, Laboratorio Nacional de Referencia en Micología Clínica, Instituto Nacional de Enfermedades Infecciosas, ANLIS "Dr. Carlos G. Malbrán", Argentina
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Yang X, Song Y, Liang T, Wang Q, Li R, Liu W. Application of laser capture microdissection and PCR sequencing in the diagnosis of Coccidioides spp. infection: A case report and literature review in China. Emerg Microbes Infect 2021; 10:331-341. [PMID: 33576325 PMCID: PMC7919914 DOI: 10.1080/22221751.2021.1889931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 01/19/2021] [Accepted: 02/09/2021] [Indexed: 02/08/2023]
Abstract
Coccidioidomycosis is endemic to California, Arizona, and Mexico. In recent years, the reported cases of coccidioidomycosis have increased in nonendemic regions. Here, we reported a case of imported pulmonary coccidioidomycosis in a Chinese patient. A 63-year-old man presented with dry cough and fatigue for 6 months, and a computed tomography scan revealed a solitary nodule in the right lower lung and small nodules in both lungs. The diagnosis of coccidioidomycosis was initially confirmed by histopathologic examination. The pathogen Coccidioides spp. was identified by laser capture microdissection (LCM) combined with subsequent molecular techniques based on the positive histopathologic features. Additionally, we reviewed 47 reported cases of coccidioidomycosis in China. The number of reported cases is increasing, and the incidence of disseminated infection has exhibited a trend of shifting towards healthy young adults in China. Since clinical presentations and imaging findings lack specificity, a majority of domestic cases of coccidioidomycosis were initially misdiagnosed as tumours or tuberculosis. Moreover, the diagnosis of endemic mycoses may be challenging because of their rarity and the limited availability of diagnostic tests. The diagnosis was mainly confirmed by histopathological examination. The species involved were identified based on positive cultures in only 4 cases. To our knowledge, this is the first study to use LCM and molecular techniques to identify Coccidioides spp. in the histopathologically positive but uncultivable specimen. Comparing with previous reported studies, LCM combined with nucleic acid amplification techniques improve the ability of species identification for the timely diagnosis of coccidioidomycosis.
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Affiliation(s)
- Xinyu Yang
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Research Center for Medical Mycology, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Peking University First Hospital, Beijing, People’s Republic of China
| | - Yinggai Song
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Research Center for Medical Mycology, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Peking University First Hospital, Beijing, People’s Republic of China
| | - TianYu Liang
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Research Center for Medical Mycology, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Peking University First Hospital, Beijing, People’s Republic of China
| | - Qiqi Wang
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Research Center for Medical Mycology, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Peking University First Hospital, Beijing, People’s Republic of China
| | - Ruoyu Li
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Research Center for Medical Mycology, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Peking University First Hospital, Beijing, People’s Republic of China
| | - Wei Liu
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Research Center for Medical Mycology, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Peking University First Hospital, Beijing, People’s Republic of China
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Abstract
Coccidioidomycosis is an endemic mycosis of the southern United States, Northern Mexico, and South America. Primary cutaneous coccidioidomycosis, despite being a very rare clinical presentation, has shown an increasing incidence. An extensive literature search for cutaneous coccidioidomycosis cases was performed using the OLDMEDLINE, PubMed, Cochrane, LILACS and Google Scholar databases for studies published from January 1927 through December 21, 2019. Forty-two observational studies were included totaling 82 cases of primary cutaneous coccidioidomycosis. Narrative reviews, systematic reviews, and meta-analyses were also included. Additionally, an original case was included. Patients with primary cutaneous coccidioidomycosis share the same geographical and epidemiological characteristics as those with pulmonary or disseminated coccidioidomycosis. Most of the imported cases came from endemic areas. A large portion of cases had prior local skin trauma. Tissue culture is still the leading diagnostic method; nevertheless, molecular techniques such as polymerase chain reaction (PCR) are currently relevant to differentiate between species. First-line treatment consists of azoles; however, it has an excellent prognosis even without treatment. Primary cutaneous coccidioidomycosis should be considered a differential diagnosis of unusual infections or neoformations in any part of the body in resident populations of endemic areas or in patients with a previous history of travel to these areas.
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Affiliation(s)
- Irving Llibran Reyna-Rodríguez
- Dermatology Department, Facultad de Medicina y Hospital Universitario "Dr. José E. Gonzalez", Universidad Autonoma de Nuevo Leon, Nuevo Leon, Avenida Francisco I. Madero y Avenida Gonzalitos S/N, Colonia Mitras Centro, 64460, Monterrey, Mexico
| | - Jorge Ocampo-Candiani
- Dermatology Department, Facultad de Medicina y Hospital Universitario "Dr. José E. Gonzalez", Universidad Autonoma de Nuevo Leon, Nuevo Leon, Avenida Francisco I. Madero y Avenida Gonzalitos S/N, Colonia Mitras Centro, 64460, Monterrey, Mexico
| | - Sonia Chavez-Alvarez
- Dermatology Department, Facultad de Medicina y Hospital Universitario "Dr. José E. Gonzalez", Universidad Autonoma de Nuevo Leon, Nuevo Leon, Avenida Francisco I. Madero y Avenida Gonzalitos S/N, Colonia Mitras Centro, 64460, Monterrey, Mexico.
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Oltean HN, Springer M, Bowers JR, Barnes R, Reid G, Valentine M, Engelthaler DM, Toda M, McCotter OZ. Suspected Locally Acquired Coccidioidomycosis in Human, Spokane, Washington, USA. Emerg Infect Dis 2020; 26:606-609. [PMID: 31922952 PMCID: PMC7045822 DOI: 10.3201/eid2603.191536] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The full geographic range of coccidioidomycosis is unknown, although it is most likely expanding with environmental change. We report an apparently autochthonous coccidioidomycosis patient from Spokane, Washington, USA, a location to which Coccidioides spp. are not known to be endemic.
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Kaur M, King S, Fotouhie A, Zangeneh TT. Unusual Presentations of Coccidioidomycosis in Conjunction With Autoimmune Syndromes: A Literature Review and Case Series. J Clin Rheumatol 2020; 26:e43-e47. [PMID: 32073532 DOI: 10.1097/rhu.0000000000000825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Manjinder Kaur
- Division of Rheumatology, Department of Internal Medicine, University of Arizona, Tucson, AZ Department of Internal Medicine, College of Medicine, University of Arizona, Tucson, AZ Department of Internal Medicine, College of Medicine, University of Arizona, Tucson, AZ; Division of Infectious Disease, The Valley Fever Center for Excellence, Department of Internal Medicine, University of Arizona, Tucson, AZ
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6
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Kollath DR, Miller KJ, Barker BM. The mysterious desert dwellers: Coccidioides immitis and Coccidioides posadasii, causative fungal agents of coccidioidomycosis. Virulence 2019; 10:222-233. [PMID: 30898028 PMCID: PMC6527015 DOI: 10.1080/21505594.2019.1589363] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/07/2019] [Accepted: 02/25/2019] [Indexed: 01/31/2023] Open
Abstract
The genus Coccidioides consists of two species: C. immitis and C. posadasii. Prior to 2000, all disease was thought to be caused by a single species, C. immitis. The organism grows in arid to semiarid alkaline soils throughout western North America and into Central and South America. Regions in the United States, with highest prevalence of disease, include California, Arizona, and Texas. The Mexican states of Baja California, Coahuila, Sonora, and Neuvo Leon currently have the highest skin test positive results. Central America contains isolated endemic areas in Guatemala and Honduras. South America has isolated regions of high endemicity including areas of Colombia, Venezuela, Argentina, Paraguay, and Brazil. Although approximately 15,000 cases per year are reported in the United States, actual disease burden is estimated to be in the hundreds of thousands, as only California and Arizona have dedicated public health outreach, and report and track disease reliably. In this review, we survey genomics, epidemiology, ecology, and summarize aspects of disease, diagnosis, prevention, and treatment.
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Affiliation(s)
- Daniel R. Kollath
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Karis J. Miller
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Bridget M. Barker
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
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Perez-Alba E, Ortiz-Meza IA, Ceceñas-Falcón LÁ, Camacho-Ortiz A. Multiple opportunistic infections in a patient with human immunodeficiency virus infection. Clin Microbiol Infect 2019; 26:71-72. [PMID: 31574338 DOI: 10.1016/j.cmi.2019.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 09/15/2019] [Accepted: 09/18/2019] [Indexed: 11/18/2022]
Affiliation(s)
- E Perez-Alba
- Servicio de Infectología, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey Mexico; Gonzalitos y Madero SN, Monterrey NL, Mexico
| | - I A Ortiz-Meza
- Gonzalitos y Madero SN, Monterrey NL, Mexico; Departamento de Anatomía Patológica Y Citopatología, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey Mexico
| | - L Á Ceceñas-Falcón
- Gonzalitos y Madero SN, Monterrey NL, Mexico; Departamento de Anatomía Patológica Y Citopatología, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey Mexico
| | - A Camacho-Ortiz
- Gonzalitos y Madero SN, Monterrey NL, Mexico; Coordinación de Epidemiología Hospitalaria, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey Mexico.
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Reyes-Montes MDR, Frías-De-León MG, Victoriano-Pastelín I, Acosta-Altamirano G, Duarte-Escalante E. Design and evaluation of an AFLP molecular marker for the detection of Coccidioides spp. in biological samples. Braz J Infect Dis 2019; 23:322-330. [PMID: 31539511 PMCID: PMC9428003 DOI: 10.1016/j.bjid.2019.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/14/2019] [Accepted: 08/16/2019] [Indexed: 12/01/2022] Open
Abstract
At present, there is no standardized marker that is routinely used in clinical laboratories to diagnose coccidioidomycosis. Thus, the goals of this study were to obtain a sequence characterized amplified region (SCAR) marker for the identification of Coccidioides spp., evaluate its specificity and sensitivity in fungal DNA-spiked blood and sputum samples, and compare it with previously described molecular markers. Specific amplified fragment length polymorphism (AFLP) amplicons for Coccidioides immitis and Coccidioides posadasii were cloned into the vector pGEM® -T Easy vector and sequenced to develop a SCAR marker. Oligonucleotides were designed to identify Coccidioides spp. by polymerase chain reaction (PCR), and the specificity and sensitivity of these oligonucleotides were tested with the DNA from related pathogens. The specificity and sensitivity of the SCAR marker was evaluated with blood and sputum samples spiked with Coccidioides DNA and compared with other previously described markers (621, GAC2, and Ag2/PRA). In addition, the conditions for its use were established using biological samples. A specific marker named SCAR300 was obtained to identify Coccidioides spp. that exhibited good sensitivity and specificity. The results showed that all of the markers tested in this study can identify Coccidioides spp. However, the SCAR300 and 621 markers were the most sensitive, whereas the SCAR300 marker was the most specific. Thus, the SCAR300 marker is a useful tool to identify Coccidioides spp.
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Affiliation(s)
- María Del Rocío Reyes-Montes
- Facultad de Medicina (UNAM), Departamento de Microbiología y Parasitología, Laboratorio de Micología Molecular, Ciudad de México, Mexico
| | | | - Isai Victoriano-Pastelín
- Facultad de Medicina (UNAM), Departamento de Microbiología y Parasitología, Laboratorio de Micología Molecular, Ciudad de México, Mexico
| | - Gustavo Acosta-Altamirano
- Hospital Regional de Alta Especialidad de Ixtapaluca, Dirección de Investigación, Ixtapaluca, Mexico
| | - Esperanza Duarte-Escalante
- Facultad de Medicina (UNAM), Departamento de Microbiología y Parasitología, Laboratorio de Micología Molecular, Ciudad de México, Mexico.
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Oltean HN, Etienne KA, Roe CC, Gade L, McCotter OZ, Engelthaler DM, Litvintseva AP. Utility of Whole-Genome Sequencing to Ascertain Locally Acquired Cases of Coccidioidomycosis, Washington, USA. Emerg Infect Dis 2019; 25:501-506. [PMID: 30789132 PMCID: PMC6390764 DOI: 10.3201/eid2503.181155] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Coccidioidomycosis is an emerging fungal infection in Washington, USA, and the epidemiology of the disease in this state is poorly understood. We used whole-genome sequencing to differentiate locally acquired cases in Washington on the basis of the previously identified phylogeographic population structure of Coccidioides spp. Clinical isolates from coccidioidomycosis cases involving possible Washington soil exposure were included. Of 17 human infections with epidemiologic evidence of possible local acquisition, 4 were likely locally acquired infections and 13 were likely acquired outside Washington. Isolates from locally acquired cases clustered within the previously established Washington clade of C. immitis. Genetic differences among these strains suggest multiple environmental reservoirs of C. immitis in the state.
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Abstract
We report 5 cases of coccidioidomycosis in animals that were acquired within Washington, USA, and provide further evidence for the environmental endemicity of Coccidioides immitis within the state. Veterinarians should consider coccidioidomycosis in animals with compatible clinical signs that reside in, or have traveled to, south central Washington.
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12
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Abstract
The recorded history of coccidioidomycosis began in 1892 with the report of the illness of Domingo Escurra by Alejandro Posadas followed by a description of the first North American cases by Rixford and Gilchrist. Originally considered a protozoan, William Ophüls determined that Coccidioides was a fungus and that the lungs were the apparent initial site of infection. During the 1930s, both Gifford and Dickson determined that a self-limited illness, Valley Fever, was caused by the same fungus that caused the often fatal coccidioidal granuloma. Charles Smith, over a period of approximately 2 decades, comprehensively described the clinical and geographic epidemiology of coccidioidomycosis in California. Demosthenes Pappagianis continued this work after Smith's death. In 1957, one year before Marshall Fiese published his masterful monograph on coccidioidomycosis, the use of the first effective agent for the therapy of coccidioidomycosis, amphotericin B, was reported. This was followed by descriptions of its appropriate clinical use by William Winn and by Hans Einstein, among others. The development of the much less toxic azole antifungal agents greatly simplified therapy in many cases, but much of the management of patients with coccidioidomycosis still relies more on art than science. The search for the “Holy Grail” - a vaccine capable of preventing this disease-continues.
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Affiliation(s)
- Stan Deresinski
- Stanford University, Department of Medicine, Stanford, California, USA
- To whom correspondence should be addressed. Stan Deresinski MD, Stanford University, Department of Medicine, Stanford, California, USA. Tel: 650.723.9062; Fax: 650.498.9876; E-mail:
| | - Laurence F Mirels
- California Institute for Medical Research, San Jose, California, USA
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Laws RL, Cooksey GS, Jain S, Wilken J, McNary J, Moreno E, Michie K, Mulkerin C, McDowell A, Vugia D, Materna B. Coccidioidomycosis Outbreak Among Workers Constructing a Solar Power Farm - Monterey County, California, 2016-2017. MMWR Morb Mortal Wkly Rep 2018; 67:931-934. [PMID: 30138303 PMCID: PMC6107319 DOI: 10.15585/mmwr.mm6733a4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In January 2017, two local health departments notified the California Department of Public Health (CDPH) of three cases of coccidioidomycosis among workers constructing a solar power installation (solar farm) in southeastern Monterey County. Coccidioidomycosis, or Valley fever, is an infection caused by inhalation of the soil-dwelling fungus Coccidioides, which is endemic in the southwestern United States, including California. After a 1–3 week incubation period, coccidioidomycosis most often causes influenza-like symptoms or pneumonia, but rarely can lead to severe disseminated disease or death (1). Persons living, working, or traveling in areas where Coccidioides is endemic can inhale fungal spores; workers who are performing soil-disturbing activities are particularly at risk. CDPH previously investigated one outbreak among solar farm construction workers that started in 2011 and made recommendations for reducing risk for infection, including worker education, dust suppression, and use of personal protective equipment (2,3). For the current outbreak, the CDPH, in collaboration with Monterey County and San Luis Obispo County public health departments, conducted an investigation that identified nine laboratory-confirmed cases of coccidioidomycosis among 2,410 solar farm employees and calculated a worksite-specific incidence rate that was substantially higher than background county rates, suggesting that illness was work-related. The investigation assessed risk factors for potential occupational exposures to identify methods to prevent further workplace illness.
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Piccione J, Reed SD. Pathology in Practice. J Am Vet Med Assoc 2018; 252:1481-1483. [PMID: 29889643 DOI: 10.2460/javma.252.12.1481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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15
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Alvarado P, Teixeira MDM, Andrews L, Fernandez A, Santander G, Doyle A, Perez M, Yegres F, Barker BM. Detection of Coccidioides posadasii from xerophytic environments in Venezuela reveals risk of naturally acquired coccidioidomycosis infections. Emerg Microbes Infect 2018; 7:46. [PMID: 29593263 PMCID: PMC5874253 DOI: 10.1038/s41426-018-0049-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 01/10/2018] [Accepted: 01/29/2018] [Indexed: 01/09/2023]
Abstract
A wide range of mammals are susceptible to infection by the fungal species Coccidioides immitis and C. posadasii. In humans, 60% of infections are asymptomatic; however, certain patients may develop a severe and deep systemic mycosis called coccidioidomycosis. Genetic analysis suggests that the majority of clinical isolates recovered from South America are C. posadasii; however, little is known about the prevalence, species distribution, and ecological factors that favor the occurrence of this pathogen in those areas. By using a combined quantitative polymerase chain reaction (qPCR)-based approach and mycobiome amplicon sequencing, we provide evidence that at least two genotypes of C. posadasii are found in the xerophytic environment in Venezuela. We detected a 3806-fold range in the amount of Coccidioides DNA when comparing among the sampled locations, which indicates that human exposure risk is variable, and is one critical factor for disease manifestation. We identified fungal communities that are correlated with a higher prevalence of C. posadasii, suggesting that a combination of specific microbes and a xeric microenvironment may favor the growth of Coccidioides in certain locations. Moreover, we discuss the use of a combinatorial approach, using both qPCR and deep-sequencing methods to assess and monitor fungal pathogen burden at outbreak sources.
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Affiliation(s)
- Primavera Alvarado
- Laboratorio de Micología, Servicio Autonomo Instituto de Biomedicina Dr. Jacinto Convit, Caracas, 4043, Venezuela
| | | | - Lela Andrews
- Environmental Genetics and Genomics Laboratory, Northern Arizona University, Flagstaff, AZ, 86011, USA
| | - Alexis Fernandez
- Laboratorio de Inmunología II, Servicio Autónomo Instituto de Biomedicina Dr. Jacinto Convit, Caracas, 4043, Venezuela
| | - Gerardo Santander
- Laboratory Geomatics, Universidad Bolivariana de Venezuela, Caracas, 1040, Venezuela
| | - Adina Doyle
- Division of Pathogen Genomics, Translational Genomics Research Institute-North, Flagstaff, AZ, 86005, USA
| | - Magaly Perez
- Laboratory Geomatics, Universidad Bolivariana de Venezuela, Caracas, 1040, Venezuela
| | - Francisco Yegres
- Laboratorio de Investigación y Apoyo Docente del Santa Ana (LIADSA), Universidad Nacional Experimental Francisco de Miranda (UNEFM), Coro, 4101, Venezuela
| | - Bridget Marie Barker
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, 86011, USA.
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Laffer M, Ackerman L. Coccidioidomycosis. Skinmed 2018; 16:51-53. [PMID: 29551116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A 23-year-old man presented with new-onset pruritic and painful urticarial lesions and targetoid erythematous plaques on both palms, the trunk, and the upper and lower extremities (Figure 1). Additionally, small pustules were discovered on the neck (Figure 2), and there with edematous erythematous vermillion lips with splaying onto the cutaneous lips without ulceration. The patient stated he had had a fever before the eruption, fatigue, chills, myalgias, and sore throat. A chest x-ray was obtained and showed bilateral infiltrates. Two 4-mm punch biopsies were performed on the left forearm and left side of the neck; a resulting section from the left forearm is shown in Figure 3.
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Affiliation(s)
- Matthew Laffer
- Macomb Center, St. John Macomb-Oakland Hospital, Warren, MI
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17
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Abstract
Although Coccidioides genotypes are highly genetically variable,
they cluster into discrete populations, which has implications for human
infections. During the past 20 years, a general picture of the genetic diversity and population
structure of Coccidioides, the causal agent of coccidioidomycosis
(Valley fever), has emerged. The genus consists of 2 genetically diverse species,
C. immitis and C. posadasii, each of which
contains 1 or more distinct populations with limited gene flow. Genotypic data
indicate that C. immitis is divided into 2 subpopulations (central
and southern California populations) and C. posadasii is divided
into 3 subpopulations (Arizona, Mexico, and Texas/South America populations).
However, admixture within and among these populations and the current paucity of
environmental isolates limit our understanding of the population genetics of
Coccidioides. We assessed population structure of
Coccidioides in Arizona by analyzing 495 clinical and
environmental isolates. Our findings confirm the population structure as previously
described and indicate a finer scale population structure in Arizona. Environmental
isolates appear to have higher genetic diversity than isolates from human
patients.
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Kundu MC, Ringenberg MA, d'Epagnier DL, Haag HL, Maguire S. Coccidioidomycosis in an Indoor-housed Rhesus Macaque ( Macaca mulatta). Comp Med 2017; 67:452-455. [PMID: 28935008 PMCID: PMC5621574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 12/27/2016] [Accepted: 02/27/2017] [Indexed: 06/07/2023]
Abstract
Coccidioides spp. are saprophytic, dimorphic fungi that are endemic to arid climates, are capable of infecting many species, and result in diverse clinical presentations. An indoor-housed laboratory rhesus macaque presented with weight loss and decreased activity and appetite. During the diagnostic evaluation, a bronchiolar-alveolar pattern in the cranial lung lobes, consistent with bronchopneumonia, was noted on radiographs. Given the poor prognosis, the macaque was euthanized. Confirming the radiographic assessment, gross necropsy findings included multifocal to coalescing areas of consolidation in the right and left cranial lung lobes. Microscopically, the consolidated regions were consistent with a pyogranulomatous bronchopneumonia and contained round, nonbudding, fungal yeast structures considered to be morphologically consistent with Coccidioides immitis. Culture and colony morphology results were confirmed through additional diagnostic testing. Sequencing of the D1-D2 domain of the 28S large ribosomal subunit positively matched with a known sequence specific to C. immitis. Serology for Coccidioides spp. by both latex agglutination (IgM) and immunodiffusion (IgG) was positive. In this rhesus macaque, the concordant results from histology, culture, DNA sequencing, and serology were collectively used to confirm the diagnosis of coccidioidomycosis. This animal likely acquired a latent pulmonary infection with Coccidioides months prior to arrival, when housed outdoors in a Coccidioides-endemic area. The nonspecific clinical presentation in this macaque, coupled with the recent history of indoor housing and lag between clinical presentation and outdoor housing, can make similar diagnostic cases challenging and highlights the need for awareness regarding animal source when making an accurate diagnosis in an institutional laboratory setting.
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Affiliation(s)
- Mila C Kundu
- Integrated Biological Platform Sciences, GlaxoSmithKline Research and Development, Collegeville, Pennsylvania, Veterinary Sciences, Bristol-Myers Squibb, New Brunswick, New Jersey
| | - Michael A Ringenberg
- Integrated Biological Platform Sciences, GlaxoSmithKline Research and Development, Collegeville, Pennsylvania
| | - Denise L d'Epagnier
- Integrated Biological Platform Sciences, GlaxoSmithKline Research and Development, Collegeville, Pennsylvania
| | - Heather L Haag
- Integrated Biological Platform Sciences, GlaxoSmithKline Research and Development, Collegeville, Pennsylvania
| | - Sean Maguire
- Integrated Biological Platform Sciences, GlaxoSmithKline Research and Development, Collegeville, Pennsylvania;,
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19
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Montgomery MW, Yawetz S, Levy BD, Loscalzo J. Back to the History. N Engl J Med 2017; 376:1783-1788. [PMID: 28467866 DOI: 10.1056/nejmcps1607608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Mary W Montgomery
- From the Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston
| | - Sigal Yawetz
- From the Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston
| | - Bruce D Levy
- From the Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston
| | - Joseph Loscalzo
- From the Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston
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20
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Colson AJ, Vredenburgh L, Guevara RE, Rangel NP, Kloock CT, Lauer A. Large-Scale Land Development, Fugitive Dust, and Increased Coccidioidomycosis Incidence in the Antelope Valley of California, 1999-2014. Mycopathologia 2017; 182:439-458. [PMID: 28084574 DOI: 10.1007/s11046-016-0105-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 12/16/2016] [Indexed: 11/26/2022]
Abstract
Ongoing large-scale land development for renewable energy projects in the Antelope Valley, located in the Western Mojave Desert, has been blamed for increased fugitive dust emissions and coccidioidomycosis incidence among the general public in recent years. Soil samples were collected at six sites that were destined for solar farm construction and were analyzed for the presence of the soil-borne fungal pathogen Coccidioides immitis which is endemic to many areas of central and southern California. We used a modified culture-independent nested PCR approach to identify the pathogen in all soil samples and also compared the sampling sites in regard to soil physical and chemical parameters, degree of disturbance, and vegetation. Our results indicated the presence of C. immitis at four of the six sites, predominantly in non-disturbed soils of the Pond-Oban complex, which are characterized by an elevated pH and salt bush communities, but also in grassland characterized by different soil parameters and covered with native and non-native annuals. Overall, we were able to detect the pathogen in 40% of the soil samples (n = 42). Incidence of coccidioidomycosis in the Antelope Valley was positively correlated with land use and particulate matter in the air (PM10) (Pearson correlation coefficient >0.5). With the predicted population growth and ongoing large-scale disturbance of soil in the Antelope Valley in coming years, incidence of coccidioidomycosis will likely further increase if policy makers and land developers continue to ignore the risk of grading land without implementing long-term dust mitigation plans in Environmental Impact Reports.
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Affiliation(s)
- Aaron J Colson
- Department of Biology, California State University Bakersfield (CSUB), 9001 Stockdale Highway, Bakersfield, CA, 93311-1022, USA
| | - Larry Vredenburgh
- Bureau of Land Management, Bakersfield Field Office, 3801 Pegasus Drive, Bakersfield, CA, 93308, USA
| | - Ramon E Guevara
- County of Los Angeles Department of Public Health, 600 S. Commonwealth Ave, Suite 700, Los Angeles, CA, 90005, USA
| | - Natalia P Rangel
- Department of Biology, California State University Bakersfield (CSUB), 9001 Stockdale Highway, Bakersfield, CA, 93311-1022, USA
| | - Carl T Kloock
- Department of Biology, California State University Bakersfield (CSUB), 9001 Stockdale Highway, Bakersfield, CA, 93311-1022, USA
| | - Antje Lauer
- Department of Biology, California State University Bakersfield (CSUB), 9001 Stockdale Highway, Bakersfield, CA, 93311-1022, USA.
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21
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Pitcher JH, Zuckerman JB. Coccidioides Immitis Infection with Involvement of the Airway. Conn Med 2016; 80:539-541. [PMID: 29772139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Coccidioides immitis is a fungus endemic to the southwest United States and can present as an asymptomatic infection, acute pneumonia, chronic progressive pneumonia, or disseminated extrapulmonary infection which most commonly involves the skin, lymph nodes, bones, joints, or meninges. Diagnosis can be made by serologic testing or by biopsy or culture of affected tissue. Acute pneumonia due to fungi cannot be readily distinguished from bacterial pneumonia without specific diagnostic testing. Occasionally, endobronchial/tracheal lesions can be found on bronchoscopy in patients with fungal pneumonia, and when present, should raise suspicion for this entity. We present a case of acute pneumonia due to C. immitis in a non-endemic region thatwas rapidly diagnosed by biopsy of an endobronchial excrescence. We discuss previous reports of airway involvement in fungal infections and the importance of direct discussion with a pathologist when attempting to identify regionally uncommon organisms.
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22
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Hurtgen BJ, Castro-Lopez N, Jiménez-Alzate MDP, Cole GT, Hung CY. Preclinical identification of vaccine induced protective correlates in human leukocyte antigen expressing transgenic mice infected with Coccidioides posadasii. Vaccine 2016; 34:5336-5343. [PMID: 27622300 DOI: 10.1016/j.vaccine.2016.08.078] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 08/19/2016] [Accepted: 08/29/2016] [Indexed: 01/19/2023]
Abstract
There is an emerging interest to develop human vaccines against medically-important fungal pathogens and a need for a preclinical animal model to assess vaccine efficacies and protective correlates. HLA-DR4 (DRB1∗0401 allele) transgenic mice express a human major histocompatibility complex class II (MHC II) receptor in such a way that CD4+ T-cell response is solely restricted by this human molecule. In this study HLA-DR4 transgenic mice were immunized with a live-attenuated vaccine (ΔT) and challenged by the intranasal route with 50-70 Coccidioides posadasii spores, a potentially lethal dose. The same vaccination regimen offers 100% survival for C57BL/6 mice. Conversely, ΔT-vaccinated HLA-DR4 mice displayed 3 distinct manifestations of Coccidioides infection including 40% fatal acute (FAD), 30% disseminated (DD) and 30% pulmonary disease (PD). The latter 2 groups of mice had reduced loss of body weight and survived to at least 50days postchallenge (dpc). These results suggest that ΔT vaccinated HLA-DR4 mice activated heterogeneous immunity against pulmonary Coccidioides infection. Vaccinated HLA-DR4 mice displayed early expansion of Th1 and Th17 cells and recruitment of inflammatory innate cells into Coccidioides-infected lungs during the first 9dpc. While contraction rates of Th cells and the inflammatory response during 14-35dpc significantly differed among the 3 groups of vaccinated HLA-DR4 mice. The FAD group displayed a sharply reduced Th1 and Th17 response, while overwhelmingly recruiting neutrophils into lungs during 9-14days. The FAD group approached moribund by 14dpc. In contrast, vaccinated HLA-DR4 survivors gradually contracted Th cells and inflammatory response with the greatest rate in the PD group. While vaccinated HLA-DR4 mice are susceptible to Coccidioides infection, they are useful for evaluation of vaccine efficacy and identification of immunological correlates against this mycosis.
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Affiliation(s)
- Brady J Hurtgen
- Department of Biology and South Texas Center for Emerging Infectious Diseases, University of Texas, San Antonio, TX, USA; Department of Microbiology and Immunology, University of Texas Health Science Center at San Antonio, TX, USA
| | - Natalia Castro-Lopez
- Department of Biology and South Texas Center for Emerging Infectious Diseases, University of Texas, San Antonio, TX, USA
| | - Maria Del Pilar Jiménez-Alzate
- Department of Biology and South Texas Center for Emerging Infectious Diseases, University of Texas, San Antonio, TX, USA; Grupo de Micología Médica, Department of Microbiology and Parasitology, School of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Garry T Cole
- Department of Biology and South Texas Center for Emerging Infectious Diseases, University of Texas, San Antonio, TX, USA; Department of Microbiology and Immunology, University of Texas Health Science Center at San Antonio, TX, USA
| | - Chiung-Yu Hung
- Department of Biology and South Texas Center for Emerging Infectious Diseases, University of Texas, San Antonio, TX, USA; Immune Defense Core, University of Texas, San Antonio, TX, USA.
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23
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Rivard SC, Satter E. Primary Cutaneous Coccidioidomycosis Presenting as a Recurrent Preauricular Cyst. Skinmed 2016; 14:142-144. [PMID: 27319963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A 31-year-old Filipino active duty marine presented with a 2-year history of a waxing and waning nodule on his left cheek that had been incised and drained on multiple occasions. The patient had no significant medical history other than a positive purified protein derivative test with negative chest x-ray finding treated with a 9-month course of isoniazid in 2010. He denied cough, fever, chills, night sweats, weight loss, joint/bone pain, or prior trauma to the area. On initial examination, there was a 1×1-cm erythematous indurated nodule associated with an overlying violaceous scar on his left preauricular cheek. Since the lesion was presumed to be an inflamed epidermal cyst, it was initially treated with 0.1 cc of interlesional triamcinolone acetonide (10 mg/cc). At 1-month follow-up, the lesion was slightly less indurated, but an excisional biopsy was performed to remove the residual nodule. The biopsy showed an essentially normal epidermis with focal dermal fibrosis below which were multiple collections of histiocytes and multinucleated giant cells surrounded by a dense lymphoplasmacytic infiltrate with numerous eosinophils (Figure 1). A few multinucleated giant cells contained large thick-walled spherules, some with endospores, consistent with Coccidioides immitis (Figure 2). Serological tests showed positive serum for C immitis IgG antibodies with low levels of complement-fixing antibodies (1:2). IgM antibodies were negative. Findings from chest x-ray and bone scan failed to reveal evidence of systemic disease. Although the infectious disease physician felt that the patient most likely had primary cutaneous coccidioidomycosis (PCC), since the duration of the infection was unknown and the patient was Filipino, thereby increasing his risk of dissemination, he was placed on a daily regimen of 400 mg of oral fluconazole until his complement fixation titers became undetectable.
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Affiliation(s)
| | - Elizabeth Satter
- Department of Dermatology and Pathology, Naval Medical Center San Diego, San Diego, CA (retired);
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Iyengar S, Chambers CJ, Chang S, Fung MA, Sharon VR. Subcorneal pustular dermatosis associated with Coccidioides immitis. Dermatol Online J 2015; 21:13030/qt35r6z6bx. [PMID: 26437157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 08/14/2015] [Indexed: 06/05/2023] Open
Abstract
Coccidioidomycosis (AKA "Valley fever") is a primary pulmonary infection via airborne spores released from coccidioides immitis in the soil. Reactive cutaneous eruptions resulting from the pulmonary infection are difficult to diagnose because skin biopsies do not contain the organism. We present an adolescent male with primary pulmonary C.immitis infection manifesting with biopsy proven subcorneal pustular dermatosis. Serological studies revealed increasingly positive titers for coccidioidomycosis and symptoms resolved promptly following initiation of systemic antifungal therapy. Our unique case presentation illustrates subcorneal pustular dermatosis as a reactive eruption owing to primary pulmonary coccidioidomycosis. An association between the two conditions warrants further investigation.
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Abstract
Coccidioides spp. fungi, which are present in soil in the southwestern United States, can become airborne when the soil is disrupted, and humans who inhale the spores can become infected. In 2012, our institution in Maricopa County, Arizona, USA, began a building project requiring extensive excavation of soil. One year after construction began, we compared the acquisition of coccidioidomycosis in employees working adjacent to the construction site (campus A) with that of employees working 13 miles away (campus B). Initial testing indicated prior occult coccidioidal infection in 20 (11.4%) of 176 campus A employees and in 19 (13.6%) of 140 campus B employees (p = 0.55). At the 1-year follow-up, 3 (2.5%) of 120 employees from campus A and 8 (8.9%) of 90 from campus B had flow cytometric evidence of new coccidioidal infection (p = 0.04). The rate of coccidioidal acquisition differed significantly between campuses, but was not higher on the campus with construction.
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26
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Affiliation(s)
- Anthony P. Cannella
- *Address correspondence to Anthony P. Cannella, 9500 Gilman Drive, Mail Code 0741, Palade Laboratories, Rm 125, San Diego, CA 92093-0741. E-mail:
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27
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Lauer A, Talamantes J, Castañón Olivares LR, Medina LJ, Baal JDH, Casimiro K, Shroff N, Emery KW. Combining forces--the use of Landsat TM satellite imagery, soil parameter information, and multiplex PCR to detect Coccidioides immitis growth sites in Kern County, California. PLoS One 2014; 9:e111921. [PMID: 25380290 PMCID: PMC4224400 DOI: 10.1371/journal.pone.0111921] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 10/08/2014] [Indexed: 12/29/2022] Open
Abstract
Coccidioidomycosis is a fungal disease acquired through the inhalation of spores of Coccidioides spp., which afflicts primarily humans and other mammals. It is endemic to areas in the southwestern United States, including the San Joaquin Valley portion of Kern County, California, our region of interest (ROI). Recently, incidence of coccidioidomycosis, also known as valley fever, has increased significantly, and several factors including climate change have been suggested as possible drivers for this observation. Up to date details about the ecological niche of C. immitis have escaped full characterization. In our project, we chose a three-step approach to investigate this niche: 1) We examined Landsat-5-Thematic-Mapper multispectral images of our ROI by using training pixels at a 750 m × 750 m section of Sharktooth Hill, a site confirmed to be a C. immitis growth site, to implement a Maximum Likelihood Classification scheme to map out the locations that could be suitable to support the growth of the pathogen; 2) We used the websoilsurvey database of the US Department of Agriculture to obtain soil parameter data; and 3) We investigated soil samples from 23 sites around Bakersfield, California using a multiplex Polymerase Chain Reaction (PCR) based method to detect the pathogen. Our results indicated that a combination of satellite imagery, soil type information, and multiplex PCR are powerful tools to predict and identify growth sites of C. immitis. This approach can be used as a basis for systematic sampling and investigation of soils to detect Coccidioides spp.
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Affiliation(s)
- Antje Lauer
- Department of Biology, California State University, Bakersfield, California, United States of America
| | - Jorge Talamantes
- Department of Physics & Engineering, California State University, Bakersfield, California, United States of America
| | | | - Luis Jaime Medina
- Department of Physics & Engineering, California State University, Bakersfield, California, United States of America
| | - Joe Daryl Hugo Baal
- Department of Biology, California State University, Bakersfield, California, United States of America
| | - Kayla Casimiro
- Department of Biology, California State University, Bakersfield, California, United States of America
| | - Natasha Shroff
- Department of Biology, California State University, Bakersfield, California, United States of America
| | - Kirt W. Emery
- County of Kern Public Health Services Department, Bakersfield, California, United States of America
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28
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Grishkina TA, Samygin VM. [The mode of identification of microscopic fungi of genus of Coccididoides spp. in vitro]. Klin Lab Diagn 2013:43-45. [PMID: 23984556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The article deals with analysis of morphologic characteristics of microscopic fungi of genus of Coccididoides spp. under cultivation on culture of mouse splenocytes culture. During two days, the strains of C. imitis and C. posadasii converse from filamentous to spherulic form. This process makes it possible to apply this test to identify agents of coccidioidomycosis.
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29
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Grishkina TA. [The morphologic characteristics of microscopic fungi of genus coccidioides]. Klin Lab Diagn 2012:41-44. [PMID: 22768718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The morphologic characteristics of microscopic fungi of genus Coccidioides under cultivation in nutrient mediums are studied. It is demonstrated that filamentous form of agents of coccidioidomycosis is characterized by significant polymorphism of macro- and micromorphologic signs on different stages of development ofagar culture. But C. immitis and C. posadasii have no species' differences. The dynamics of development of coccidioidomycosis strains in microcultures is analyzed as well as the intensity of sporification. The forms and sizes of arthroconidiae are also established.
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31
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Chung CR, Lee YC, Rhee YK, Chung MJ, Hong YK, Kweon EY, Park SJ. Pulmonary coccidioidomycosis with peritoneal involvement mimicking lung cancer with peritoneal carcinomatosis. Am J Respir Crit Care Med 2011; 183:135-6. [PMID: 21193791 DOI: 10.1164/ajrccm.183.1.135] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Kumar KSS, Narasimhan A, Gopalakrishnan R, Geetha N, Thirunarayanan MA, Suryanarayanan P. Coccidioidomycosis in Chennai. J Assoc Physicians India 2011; 59:122-124. [PMID: 21751654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Coccidioidomycosis is a deep mycosis caused by the fungus Coccidioides immitis. Disseminated disease can affect any part of the body. Coccidioidal synovitis is a rare manifestation of musculoskeletal coccidioidomycosis requiring aggressive treatment. We report a case of a 68 year old man who presented to our centre in Chennai with pain and restriction of movement of the elbow of 4 months duration. After being investigated, he was subjected to a synovectomy following which he was diagnosed to have coccidioidal synovitis of the elbow joint by histology and culture. He was treated with itraconazole. He was doing well on the most recent follow up. The case is presented for its rarity in India.
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34
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Affiliation(s)
- Donald C Vinh
- Division of Infectious Diseases Division of Clinical Immunology Department of Medicine Department of Medical Microbiology McGill University Health Centre Montreal, Quebec, Canada
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35
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Ho L, Schnall S, Schiller F, Holtom P. Metacarpal coccidioidal osteomyelitis. Am J Orthop (Belle Mead NJ) 2011; 40:34-36. [PMID: 21720584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Lance Ho
- Department of Orthopedic Surgery, University of Southern California, Los Angeles, CA 90033, USA.
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36
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Kormos WA, Wu CC, Branda JA, Piris A. Case records of the Massachusetts General Hospital. Case 35-2010. A 56-year-old man with cough, hypoxemia, and rash. N Engl J Med 2010; 363:2046-54. [PMID: 21083390 DOI: 10.1056/nejmcpc1003888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- William A Kormos
- Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, USA
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Abstract
Despite the advent of new antifungal agents, coccidioidal meningitis (CM) remains a difficult-to-treat condition with significant morbidity and mortality. In this study we directly compare the clinical presentation and management of patients with Coccidioides immitis meningitis in the azole era (after 1980) to that of a cohort of patients from the pre-azole era. We reviewed 30 CM cases seen at 3 Los Angeles hospitals between the years 1993 to 2008 ("2008 cohort") and compared them to 31 patients ("1980 cohort") described by Bouza et al in a previous study. The demographics and clinical presentation of patients in the 2008 cohort were similar to those of the 1980 cohort except for a higher incidence of Hispanic patients (2008: 53% vs. 1980: 6%) and a greater percentage of patients with underlying, predisposing clinical conditions (2008: 66% vs. 1980: 32%). Ten patients in the 2008 cohort had human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), a condition not reported in the earlier study. Laboratory findings were similar between the 2 groups except for a lower incidence of peripheral leukocytosis and eosinophilia in the 2008 group.There were marked differences in drug treatment between the 2 eras. In the 2008 cohort, 29 patients received fluconazole therapy: 13 were treated with fluconazole monotherapy, and 16 received a combination of fluconazole and intravenous amphotericin B. Although almost all patients (29/31) in the 1980 cohort received intrathecal amphotericin B, only 3 patients in the 2008 study received amphotericin B via this route. With respect to complications of CM, a similar percentage of patients in each cohort developed complications such as stroke and hydrocephalus. The 2008 cohort (40%) had similar mortality compared to patients in the 1980 study (39%); survivors in both groups experienced significant impairment of activities of daily living. Although recommended as first-line therapy for CM, azole-based therapies are not curative and do not necessarily prevent complications associated with the disease.CM remains a serious illness with a high rate of morbidity and mortality. Immunocompromised individuals, especially those with HIV/AIDS, are at special risk for CM and represent a greater share of the overall population with this condition. Despite the clear advantages of azole treatment in CM, new therapeutic approaches are needed to provide definitive cure and to reduce the need for long-term suppressive therapy.
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Affiliation(s)
- Glenn Mathisen
- From Cedars Sinai-UCLA Affilialted Multicampus Infectious Disease Program (GM, AS, JT, CW), Los Angeles; Cedars Sinai Medical Center, Los Angeles; Olive View-UCLA Medical Center (GM, JT, CW), Sylmar; VA West Los Angeles Medical Center, Los Angeles; Los Angeles County Department of Public Health (CW), Los Angeles; and Southern California Kaiser Permanente Medical Group (JT), Los Angeles, California
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Vasconcelos-Santos DV, Lim JI, Rao NA. Chronic coccidioidomycosis endophthalmitis without concomitant systemic involvement: a clinicopathological case report. Ophthalmology 2010; 117:1839-42. [PMID: 20471688 DOI: 10.1016/j.ophtha.2010.01.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Revised: 11/30/2009] [Accepted: 01/15/2010] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To report the diagnostic, clinical, and histopathologic features of a patient with coccidioidomycosis endophthalmitis without concomitant systemic involvement diagnosed by vitreous biopsy. DESIGN Interventional case report. PARTICIPANTS One patient. INTERVENTION Diagnostic pars plana vitrectomy, systemic and intravitreal antifungal treatment, and enucleation. MAIN OUTCOME MEASURES Diagnostic, clinical, and histopathologic features of chronic coccidioidomycosis endophthalmitis. RESULTS A 64-year-old white man from Southern California presented with chronic intraocular inflammation in the right eye that had lasted 18 months. He had been unsuccessfully treated with topical and subtenon steroids. At presentation, best-corrected visual acuity was 20/400 in the right eye and 20/20 in the left eye. Ophthalmoscopy of the right eye revealed significant vitritis and multiple yellowish chorioretinal lesions. Evaluation by an internist showed no underlying inflammatory, infectious, or neoplastic systemic illnesses. A vitreous biopsy followed by histopathologic examination showed the presence of multiple Coccidioides sp. microorganisms. The patient was then treated with intravitreal amphotericin B and oral fluconazole. Best-corrected visual acuity initially improved to 20/80, but inflammation progressed and did not respond to 2 subsequent injections of antifungals, 2 additional pars plana vitrectomies, and oral fluconazole. The eye eventually became blind and painful and was enucleated. Histopathologic examination disclosed intraocular granulomas displaying multiple Coccidioides sp. microorganisms. CONCLUSIONS Coccidioides sp. endophthalmitis may present with no concomitant systemic involvement. Histopathologic examination of the vitreous is helpful in the diagnosis. A high index of suspicion is important, especially in areas where the incidence of coccidioidomycosis is rising.
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Affiliation(s)
- Daniel V Vasconcelos-Santos
- Doheny Eye Institute and Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
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Tabor JA, O'Rourke MK. A risk factor study of coccidioidomycosis by controlling differential misclassifications of exposure and susceptibility using a landscape ecology approach. Sci Total Environ 2010; 408:2199-2207. [PMID: 20188397 DOI: 10.1016/j.scitotenv.2010.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Revised: 02/02/2010] [Accepted: 02/04/2010] [Indexed: 05/28/2023]
Abstract
State-reported coccidioidomycosis cases in Arizona have dramatically increased since 1997, raising concerns about a possible epidemic, its cause, and associated risk factors, including spatio-temporal differences in susceptibility and exposure. This stratified, two-stage, cross-sectional study evaluates inherent, socio-economic, and environmental risk factors of coccidioidomycosis from information collected during an address-based telephone survey of 5460 households containing 14,105 individuals in greater Tucson, Arizona. Three geomorphic and two demographic strata controlled for differences in group-level exposures and susceptibility, and assured recruitment of a minority population. Logistic regression of self-reported cases indicates that location of residence by geomorphic and demographic strata was a risk factor that confounded the associations of coccidioidomycosis with age, race-ethnicity, and educational attainment. The risk due to age is more evenly distributed across the population than bivariate results when individual- and group-level exposure and susceptibility factors are controlled. Similarly the association for being Hispanic decreased from strong bivariate 0.28 odds ratio to a weak multivariate 0.75. Location of residence confounded the risk due to race-ethnicity and was an effect modifier of risk due to age. Differential misclassification of exposure to Coccidioides spores and susceptibility to coccidioidomycosis was reduced through landscape stratification by demographics and geomorphic types. Landscape epidemiological studies of diseases with strong environmental and demographic determinants can reduce residual confounding and account for spatial and temporal differences between neighborhoods and at broader scales.
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Affiliation(s)
- Joseph A Tabor
- Office of Arid Lands Studies, College of Agriculture and Life Sciences, The University of Arizona, Tucson, Arizona, 85721, USA.
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Gabrielian A, Hariprasad SM. New onset of bilateral multifocal coccidioidomycosal choroiditis in a patient on oral fluconazole. Can J Ophthalmol 2010; 45:419-20. [PMID: 20379287 DOI: 10.3129/i09-270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Naidu VG, Tammineni AK, Biscopink RJ, Davis TL, Veerabagu MP. Coccidioides immitis and Mycobacterium tuberculosis diagnosed by endoscopic ultrasound. J S C Med Assoc 2009; 105:4-7. [PMID: 19331085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The use of endoscopic ultrasound in staging non-small cell lung cancer is well known. Its role in diagnosing non-malignant conditions that cause mediastinal adenopathy is still not well established. We diagnosed Coccidioides immitis and Mycobacterium tuberculosis in two patients using endoscopic ultrasound. To our knowledge this is the first case of Coccidioidomycosis to be diagnosed by endoscopic ultrasound.
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Negroni R. [Historical evolution of some clinical and epidemiological knowledge of coccidioidomycosis in the Americas]. Rev Argent Microbiol 2008; 40:246-256. [PMID: 19213250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Coccidioidomycosis is a systemic endemic mycosis caused by two dimorphic fungi of the Coccidioides genus: Coccidioides immitis and Coccidioides posadasii. This fungal infection is only endemic in the American Continent. The majority of the epidemiological, pathogenic, clinical, mycological and therapeutical findings were obtained in the U.S.A. Coccidioidomycosis was discovered in Argentina, at the end of the XIXth century by Alejandro Posadas. In the last two decades, a new endemic zone was found in the northeast of Brazil. Several countries of the region such as Mexico, Guatemala, Honduras, Venezuela and Argentina have performed epidemiological studies which allowed a better knowledge of the endemic areas and of the clinical characteristics of this mycosis.
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Affiliation(s)
- R Negroni
- Centro de Micología, Departamento de Microbiología, Parasitología e Inmunología, Facultad de Medicina, Universidad de Buenos Aires,Ciudad Autónoma de Buenos Aires, Argentina.
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Abstract
Coccidioidomycosis is a common infectious disease in the southwestern United States. Although Coccidioides species are not endemic in other areas of the country, the rapid population growth in the southwestern United States in recent decades and the increase in tourism mean that many people travel to the Southwest and return home before developing the clinical syndrome of coccidioidomycosis. In this respect, coccidioidomycosis is a disease of national importance. It can occur in various manifestations: acute pneumonia, chronic progressive pneumonia, pulmonary nodules and cavities, extrapulmonary nonmeningeal disease, and meningitis. The diagnosis is often made on the basis of serologic findings. Treatment is usually with an azole or amphotericin B, depending on the clinical manifestations and the immune status of the host. We discuss the most common clinical manifestations, the best way to make the diagnosis, and the treatment of common infections.
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Affiliation(s)
- James M Parish
- Division of Pulmonary Medicine, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA
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Ramani R, Chaturvedi V. Antifungal susceptibility profiles of Coccidioides immitis and Coccidioides posadasii from endemic and non-endemic areas. Mycopathologia 2007; 163:315-9. [PMID: 17484074 DOI: 10.1007/s11046-007-9018-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2007] [Accepted: 04/05/2007] [Indexed: 10/23/2022]
Abstract
Coccidioidomycosis is a systemic fungal infection endemic in Southwestern United States, Mexico, Central and South America. The causal agents are Coccidioides immitis and C. posadasii. A large number of cases of coccidioidomycosis in New York State residents were identified. We compared susceptibility profiles of these isolates and of C. immitis isolates from California using mycelial phase inoculum and CLSI (NCCLS) M38-A broth microdilution protocol. Minimum fungicidal concentrations (MFC) were also determined. Results indicated that geometric mean MICs of amphotericin B (AMB, 0.06 microg/ml), fluconazole (FLC, 8.0 microg/ml), itraconazole (ITC, 0.07 microg/ml), ketoconazole (KTC, 0.04 microg/ml), voriconazole (VRC, 0.04 microg/ml), posaconazole (PSC, 0.17 microg/ml) and caspofungin (CSP, 0.15 microg/ml) were in susceptible range as per breakpoints published for pathogenic Candida species. However, geometric MFC for FLC was relatively higher (52.4 microg/ml). Also, no significant difference in MIC and MFC values was evident for C. immitis and C. posadasii isolates. In conclusion, current methods for antifungal susceptibility testing yield reproducible profiles for Coccidioides species, which appear to be highly susceptible to most antifungal agents.
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Affiliation(s)
- Rama Ramani
- New York State Department of Health, Mycology Laboratory, Wadsworth Center, 120 New Scotland Ave, Albany, New York 12208-2002, USA
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Abstract
Coccidioides immitis is a fungus endemic to the southwestern United States. Susceptible hosts, including blacks, Hispanics, Filipinos, Native Americans, and those with compromised immunity, may develop disseminated disease, including fungemia. We retrospectively reviewed the records of all patients (n = 33) with Coccidioides immitis fungemia (CIF) at a 550-bed public hospital in Phoenix, Arizona, from 1990 to 2002. This is the largest reported series of CIF. The purpose of the study was to review the incidence, signs, symptoms, and outcomes of CIF. Twenty-nine patients had human immunodeficiency virus infection. CIF was associated with sepsis, end-stage alcoholic liver disease, and diabetes in four patients. Survival was poor; 24 of the 33 patients died within 28 days. CIF manifested as a systemic inflammatory response syndrome with progressive cardiorespiratory failure. Despite fluid loading, infusion of vasoactive agents, and mechanical ventilation with positive end-expiratory pressure, patients typically experienced a rapidly progressive course and death. CIF portends an ominous prognosis and typically occurs in the setting of advanced human immunodeficiency virus or medical or surgical crises.
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Affiliation(s)
- Silke Rempe
- Pulmonary/Critical Care, Carl T. Hayden VA Good Samaritan Medical Center, Phoenix, Arizona, USA
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Minamisawa A, Furihata K, Ushiki A, Wakamatsu T, Koyama S. [A case of pulmonary coccidioidomycosis]. Nihon Kokyuki Gakkai Zasshi 2007; 45:180-4. [PMID: 17352177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
A 32-year-old Japanese woman who had been living in Arizona, United States since two years previously was admitted to our hospital because of an abnormal shadow. Her chest X-ray films revealed a small cavity in the right middle lung field which had not been identified two years ago. The chest CT showed that it was 15 mm in diameter and located in the right S6, and open lung biopsy was performed. Histological examination revealed caseous lesion of the epithelioid granulomas, that contained spherulitic forms of endospores. Fungal cultures demonstrated barrel-shaped arthroconidia. A diagnosis of pulmonary coccidioidomycosis was made.
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Affiliation(s)
- Ayako Minamisawa
- 2nd Department of Internal Medicine and Respiratory Medicine, Nagano Red Cross Hospital
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Cordeiro RA, Brilhante RSN, Rocha MFG, Fechine MAB, Camara LMC, Camargo ZP, Sidrim JJC. Phenotypic characterization and ecological features of Coccidioides spp. from Northeast Brazil. Med Mycol 2007; 44:631-9. [PMID: 17071557 DOI: 10.1080/13693780600876546] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
This study extends phenotypic and ecological knowledge of Coccidioides spp., by describing its recovery from soils of Ceará State (Northeast Brazil) and analyzing the in vitro features of the growth of its vegetative phase. Following a human coccidioidomycosis case, Coccidioides spp. strains were isolated from 3 of 14 soil samples collected in an armadillo's burrow. Mycological analysis showed colonies with glabrous, velvety or cottony texture and an increasing quantity of arthroconidia. The overall growth rates of the strains were slower in 8% NaCl medium, maximum growth rate was obtained at 30 degrees C, and their pH tolerance ranged from 4.0 to 11.0. Several carbohydrates and polyalcohol sources could be efficiently metabolized by Coccidioides spp. strains in the mycelial form. Total absence of growth was observed in media supplemented with either L-aspartic acid or L-histidine. Whereas intense growth was found when strains were incubated with any other aminoacid sources studied. Coccidioides spp. strains did not grow in the presence of Tween 60 and Tween 80, but exhibited intense growth in Tween 20. Nicotinic acid and the toxic compounds caffeic acid and phenol could not be metabolized by any strain. All of the strains were positive for urease production and displayed intense growth in media containing cycloheximide concentrations ranging from 0.01 and 0.05%, but did not grow at 0.1 and 0.2%. The present findings confirm the importance of armadillos burrows in the ecology of Coccidioides spp. in Northeast Brazil and indicate that the fungus is a very physiologically versatile organism.
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Affiliation(s)
- R A Cordeiro
- Medical Mycology Specialized Center, Federal University of Ceará, Fortaleza, Ceará, Brazil.
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Tkachenko GA, Grishina MA, Antonov VA, Savchenko SS, Zamaraev VS, Lesovoĭ VS, Lipnitskiĭ AV. [Identification of the agents of coccidioidomycosis using polymerase chain reaction]. Mol Gen Mikrobiol Virusol 2007:25-31. [PMID: 18154078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Two pairs of primers for diagnosis of coccidioidomycosis using the method of PCR were constructed. One pair was used for identification of the two species of Coccidioides (C. immitis and C. posadasil) on the basis of MBP-1 gene. The other pair was chosen on the basis of SOWgp82 gene, which encodes an immunodominant, spherule outer wall glycoprotein for detecting only C. posadasii. The used primers allowed the agents of coccidioidomycosis to be detected using PCR with high sensitivity and specificity. The effective method of isolation of fungus DNA from soil contaminated with arthroconidia of Coccidioides spp. was developed. It includes guanidinthiocyanate-phenol-chloroform deproteinization followed by DNA purification using nuclear sorption.
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Affiliation(s)
- Deborah Helig
- Department of Cytology, University of Rochester Medical Center, Rochester, New York 14642, USA
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McGinnis MR, Smith MB, Hinson E. Use of the Coccidioides posadasii Deltachs5 strain for quality control in the ACCUPROBE culture identification test for Coccidioides immitis. J Clin Microbiol 2006; 44:4250-1. [PMID: 17088372 PMCID: PMC1698319 DOI: 10.1128/jcm.01265-06] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Coccidioides posadasii Deltachs5 is a strain that is excluded from the select agent list. Sixteen assays using test reagents from three different ACCUPROBE Coccidioides immitis culture identification test lots had an average of 132,998 relative light units (RLU), which is well beyond the 50,000-RLU positive cutoff value for the test. Coccidioides posadasii Deltachs5 is a satisfactory quality control isolate in the ACCUPROBE culture identification test for Coccidioides immitis.
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Affiliation(s)
- Michael R McGinnis
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas 77555-0740, USA.
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