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1.
Medicine (Baltimore) ; 101(35): e30361, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36107584

RESUMO

The COVID-19 pandemic has disrupted medical care worldwide and caused delays in care for many illnesses and procedures unrelated to COVID-19; however, less clear is how it may have affected diagnosis of conditions that present with similar symptoms, such as primary pulmonary coccidioidomycosis (PPC). We conducted an observational cohort study of patients diagnosed with PPC between March 1 and December 1 in 2 years: 2019 (before COVID-19) and in 2020 (after COVID-19) to compare the time from symptom onset to PPC diagnosis. Relevant demographic and clinical variables were collected, and statistical analyses were performed with the χ2 test, Wilcoxon rank sum test, and Cox proportional hazards regression analysis. During 2019, 83 patients were diagnosed with PPC. During 2020, 113 patients were diagnosed with PPC. For both groups, the median time from symptom onset to diagnosis of PPC was 14 days (P = .13). No significant differences in time to diagnosis existed between the 2 years for location of diagnosis (outpatient clinic, emergency department, or in hospital), for computed tomographic imaging performed before diagnosis, or for number of COVID-19 tests received before PPC diagnosis. In addition, there were no differences in the 2 years between the total number of clinical visits before diagnosis. However, patients in the post-COVID-19 group who had fever were diagnosed with PPC earlier than those without fever (hazard ratio, 1.77; 95% confidence interval, 1.15-2.73; P = .01). Contrary to what we expected, no significant delay in diagnosis of PPC occurred during the COVID-19 pandemic.


Assuntos
COVID-19 , Coccidioidomicose , COVID-19/diagnóstico , Teste para COVID-19 , Coccidioidomicose/diagnóstico , Coccidioidomicose/epidemiologia , Estudos de Coortes , Serviço Hospitalar de Emergência , Humanos , Pandemias
2.
BMJ Case Rep ; 15(9)2022 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-36127036

RESUMO

An elderly man without history of travel presented with complaints of intermittent fever for 2 months, cough with scanty expectoration for 15 days and history of weight loss of 5 kg in 1 year. The chest X-ray and CT scan of the thorax showed dispersed centrilobular nodules and patchy subpleural consolidation in both lungs with mediastinal lymphadenopathy. He underwent bronchoscopy and bronchoalveolar lavage culture grew Pseudomonas aeruginosa He was prescribed antibiotics based on culture sensitivity; however, patient continued to have symptoms. All relevant blood investigations were within normal limits. He underwent CT-guided biopsy of the right lung lesion during which clearing of the radio-opacities present in the initial CT scan and appearance of fresh lesions in different locations were observed. Migratory shadows were suspected. Fine-needle aspiration cytology showed features suggestive of coccidioidomycosis for which antifungals were started. After 1 month, he improved symptomatically and chest X-ray showed clearance of shadows.


Assuntos
Coccidioidomicose , Idoso , Antibacterianos/uso terapêutico , Antifúngicos/uso terapêutico , Broncoscopia , Coccidioidomicose/diagnóstico por imagem , Coccidioidomicose/tratamento farmacológico , Humanos , Pulmão/patologia , Masculino
3.
Emerg Infect Dis ; 28(9): 1842-1846, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35997543

RESUMO

We conducted a retrospective cohort study that tested 2,000 US military personnel for Coccidioides antibodies in a disease-endemic region. The overall incidence of seroconversion was 0.5 cases/100 person-years; 12.5% of persons who seroconverted had illnesses requiring medical care. No significant association was found between demographic characteristics and seroconversion or disease.


Assuntos
Coccidioidomicose , Militares , California , Coccidioides , Coccidioidomicose/epidemiologia , Coccidioidomicose/etiologia , Humanos , Incidência , Estudos Retrospectivos
4.
MMWR Surveill Summ ; 71(7): 1-14, 2022 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-36006889

RESUMO

PROBLEM/CONDITION: Coccidioidomycosis, histoplasmosis, and blastomycosis are underdiagnosed fungal diseases that often mimic bacterial or viral pneumonia and can cause disseminated disease and death. These diseases are caused by inhalation of fungal spores that have distinct geographic niches in the environment (e.g., soil or dust), and distribution is highly susceptible to climate changes such as expanding arid regions for coccidioidomycosis, the northward expansion of histoplasmosis, and areas like New York reporting cases of blastomycosis previously thought to be nonendemic. The national incidence of coccidioidomycosis, histoplasmosis, and blastomycosis is poorly characterized. REPORTING PERIOD: 2019. DESCRIPTION OF SYSTEM: The National Notifiable Diseases Surveillance System (NNDSS) tracks cases of coccidioidomycosis, a nationally notifiable condition reported to CDC by 26 states and the District of Columbia. Neither histoplasmosis nor blastomycosis is a nationally notifiable condition; however, histoplasmosis is voluntarily reported in 13 states and blastomycosis in five states. Health departments classify cases based on the definitions established by the Council of State and Territorial Epidemiologists. RESULTS: In 2019, a total of 20,061 confirmed coccidioidomycosis, 1,124 confirmed and probable histoplasmosis, and 240 confirmed and probable blastomycosis cases were reported to CDC. Arizona and California reported 97% of coccidioidomycosis cases, and Minnesota and Wisconsin reported 75% of blastomycosis cases. Illinois reported the greatest percentage (26%) of histoplasmosis cases. All three diseases were more common among males, and the proportion for blastomycosis (70%) was substantially higher than for histoplasmosis (56%) or coccidioidomycosis (52%). Coccidioidomycosis incidence was approximately four times higher for non-Hispanic American Indian or Alaska Native (AI/AN) persons (17.3 per 100,000 population) and almost three times higher for Hispanic or Latino persons (11.2) compared with non-Hispanic White (White) persons (4.1). Histoplasmosis incidence was similar across racial and ethnic categories (range: 0.9-1.3). Blastomycosis incidence was approximately six times as high among AI/AN persons (4.5) and approximately twice as high among non-Hispanic Asian and Native Hawaiian or other Pacific Islander persons (1.6) compared with White persons (0.7). More than one half of histoplasmosis (54%) and blastomycosis (65%) patients were hospitalized, and 5% of histoplasmosis and 9% of blastomycosis patients died. States in which coccidioidomycosis is not known to be endemic had more cases in spring (March, April, and May) than during other seasons, whereas the number of cases peaked slightly in autumn (September, October, and November) for histoplasmosis and in winter (December, January, and February) for blastomycosis. INTERPRETATION: Coccidioidomycosis, histoplasmosis, and blastomycosis are diseases occurring in geographical niches within the United States. These diseases cause substantial illness, with approximately 20,000 coccidioidomycosis cases reported in 2019. Although substantially fewer histoplasmosis and blastomycosis cases were reported, surveillance was much more limited and underdiagnosis was likely, as evidenced by high hospitalization and death rates. This suggests that persons with milder symptoms might not seek medical evaluation and the symptoms self-resolve or the illnesses are misdiagnosed as other, more common respiratory diseases. PUBLIC HEALTH ACTION: Improved surveillance is necessary to better characterize coccidioidomycosis severity and to improve detection of histoplasmosis and blastomycosis. These findings might guide improvements in testing practices that enable timely diagnosis and treatment of fungal diseases. Clinicians and health care professionals should consider coccidioidomycosis, histoplasmosis, and blastomycosis in patients with community-acquired pneumonia or other acute infections of the lower respiratory tract who live in or have traveled to areas where the causative fungi are known to be present in the environment. Culturally appropriate tailored educational messages might help improve diagnosis and treatment. Public health response to these three diseases is hindered because information gathered from states' routine surveillance does not include data on populations at risk and sources of exposure. Broader surveillance that includes expansion to other states, and more detail about potential exposures and relevant host factors can describe epidemiologic trends, populations at risk, and disease prevention strategies.


Assuntos
Blastomicose , Coccidioidomicose , Histoplasmose , Blastomicose/diagnóstico , Blastomicose/epidemiologia , Coccidioidomicose/diagnóstico , Coccidioidomicose/epidemiologia , Histoplasmose/diagnóstico , Histoplasmose/epidemiologia , Humanos , Incidência , Masculino , Vigilância da População , Viagem , Estados Unidos/epidemiologia
8.
BMC Infect Dis ; 22(1): 623, 2022 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-35843935

RESUMO

BACKGROUND: Pericardial disease can be a manifestation of infection and imaging can have a role in its diagnosis. coccidioidomycosis endemic fungal infection has been more frequently reported over the past few decades. Other than case reports or series, there has been no systemic study evaluating pericardial imaging findings in patients with coccidioidomycosis to the best of our knowledge. The purpose of this study was to evaluate intrathoracic computed tomographic (CT) imaging abnormalities in patients with coccidioidal infection with specific emphasis on the pericardium. METHODS: Retrospective review of radiology reports and clinical chart review was performed to identify patients with coccidioidomycosis between January 2000 and September 2021 at our medical center. Diagnosis of infection was confirmed predominately with serology. Patients were excluded if a CT was not performed within 3 months of confirmed diagnosis date and if there was concomitant additional granulomatous or fungal infection. Chest CT was reviewed for pericardial and additional intrathoracic findings. RESULTS: The final retrospective cohort consisted of 37 patients. Imaging findings included lung nodules (N = 33/37), consolidation (N = 25/37), mediastinal or hilar lymphadenopathy (N = 20/37) and pleural effusions (N = 13/37). Eleven of 37 patients (30%) had either trace pericardial fluid (N = 3/37) or small pericardial effusions (N = 8/37). One patient had pericardial enhancement/thickening and history of pericardial tamponade. No other patient had clinical pericarditis or pericardial tamponade. Pericardial calcifications were not seen in any patient. Pericardial effusion was statistically associated with presence of pleural effusion as 9/13 patients with pleural effusion had pericardial effusion versus 2/26 patients without pleural effusion had pericardial effusion (p < 0.001). Otherwise patients with and without pericardial imaging findings were similar in terms of demographics, comorbidities and other imaging findings. CONCLUSION: Pulmonary parenchymal pathology is a common manifestation of coccidioidal infection. Most patients with coccidioidomycosis do not have pericardial imaging abnormalities on CT.


Assuntos
Tamponamento Cardíaco , Coccidioidomicose , Derrame Pericárdico , Derrame Pleural , Coccidioidomicose/diagnóstico por imagem , Coccidioidomicose/microbiologia , Humanos , Derrame Pericárdico/diagnóstico por imagem , Derrame Pleural/microbiologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
9.
Artigo em Inglês | MEDLINE | ID: mdl-35742514

RESUMO

The soil-borne fungal disease coccidioidomycosis (Valley fever) is prevalent across the southwestern United States (US). Previous studies have suggested that the occurrence of this infection is associated with anomalously wet or dry soil moisture states described by the "grow and blow" hypothesis. The growth of coccidioidomycosis is favored by moist conditions both at the surface and in the root zone. A statistical analysis identified two areas in Arizona and central California, with a moderate-to-high number of coccidioidomycosis cases. A Wavelet Transform Coherence (WTC) analysis between El Nino Southern Oscillation (ENSO), coccidioidomycosis cases, surface soil moisture (SSM; 0 to 5 cm) from European Space Agency-Climate Change Initiative (ESA-CCI), and shallow root zone soil moisture (RZSM; 0 to 40 cm depth) from Soil MERGE (SMERGE) was executed for twenty-four CA and AZ counties. In AZ, only SSM was modulated by ENSO. When case values were adjusted for overreporting between 2009 to 2012, a moderate but significant connection between ENSO and cases was observed at a short periodicity (2.1 years). In central CA, SSM, RZSM, and cases all had a significant link to ENSO at longer periodicities (5-to-7 years). This study provides an example of how oceanic-atmospheric teleconnections can impact human health.


Assuntos
Coccidioidomicose , Micoses , Arizona/epidemiologia , California/epidemiologia , Coccidioidomicose/epidemiologia , El Niño Oscilação Sul , Humanos , Solo
10.
Clin Infect Dis ; 75(4): 555-559, 2022 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-35717645

RESUMO

Central nervous system infection with Coccidioides spp. is fatal if untreated and complications occur even when therapy is directed by experienced clinicians. We convened a panel of clinicians experienced in the management of coccidioidal meningitis to summarize current controversies and provide consensus for the management of this difficult infection.


Assuntos
Coccidioidomicose , Meningite Fúngica , Antifúngicos/uso terapêutico , Sistema Nervoso Central , Coccidioides , Coccidioidomicose/complicações , Coccidioidomicose/diagnóstico , Coccidioidomicose/tratamento farmacológico , Humanos , Meningite Fúngica/diagnóstico , Meningite Fúngica/tratamento farmacológico
11.
Mycopathologia ; 187(4): 385-391, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35672489

RESUMO

Paracoccidiodomycosis ceti (PCM-C) is a zoonotic mycosis characterized by chronic granulomatous cutaneous lesions in cetaceans. It is distributed worldwide and is caused by an unculturable fungus; Paracoccidioides cetii. On the other hand, coccidioidomycosis (CCM), caused by Coccidioides spp., is also a zoonotic and highly pathogenic fungal infection endemic in both American continents. Even though the Far East is not an endemic area of CCM, an autochthonous case has been reported in China. Although the seroprevalence against P. cetii in captive dolphins was 61.0%, there is no information on wild dolphins living in cold waters. The present study aimed to investigate the seroprevalence against P. cetii and C. posadasii in 15 Dall's porpoises (Phocoenoides dalli) and 11 harbor porpoises (Phocoena phocoena) stranded in Hokkaido, Japan. The seroprevalence against P. cetii in the above dolphins was 26.9% (7/26), which was recorded only in Dall's porpoises (7/15), and that against C. posadasii was 15.4% (4/26), three in Dall's porpoises and one in harbor porpoise. The present study demonstrated positive seroprevalence against P. cetii and C. posadasii in wild cetaceans living in the subarctic areas of the Far East as the first records, and would issue the warning those who live in the area were exposed to the causative agent of CCM from seawater.


Assuntos
Coccidioidomicose , Golfinhos , Paracoccidioides , Phocoena , Animais , Coccidioides , Japão , Estudos Soroepidemiológicos
12.
World Neurosurg ; 164: e582-e589, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35552038

RESUMO

BACKGROUND: Shunting is an established treatment for hydrocephalus, yet reports on shunt outcomes for nonbacterial infection (NBI) hydrocephalus are limited. Furthermore, comparison of mechanisms and rates of failure for shunted NBI hydrocephalus versus more typical etiologies remains undetermined. METHODS: Patients who underwent shunting for hydrocephalus at 2 centers (1995-2020) were included. Indications for shunting were grouped as "typical" (congenital, posthemorrhagic, normal pressure hydrocephalus, malignancy-related, trauma, and idiopathic) and NBI hydrocephalus (coccidioidomycosis, cryptococcosis, and neurocysticercosis). Rates of shunt malfunction were compared. RESULTS: There were 261 patients shunted for typical hydrocephalus (48.7% male; age = 50.7 ± 21.7) and 93 patients for NBI hydrocephalus (72.0% male; age = 41.8 ± 13.2). For patients with typical hydrocephalus, 29.5% required ≥1 shunt revision, compared with 64.5% with NBI hydrocephalus (P < 1E-5). Of those with malfunction, NBI shunts required more revision operations (median = 3.0; max = 21) than typical shunts (median = 2.0; max = 6; P < 0.05). The censored median time to shunt failure for NBI hydrocephalus was 26.9 months and was not reached for typical etiologies by 180 months. Multivariate analysis showed shunts for NBI hydrocephalus were significantly more likely to fail (hazard ratio = 2.25; 95% confidence interval = 1.58-3.19). A distal pseudocyst was implicated in 30.0% and 2.6% of shunt failures for NBI and typical hydrocephalus, respectively (P < 1E-5). Sixteen (26.7%) NBI shunt failures required revision to lower-resistance systems compared to 6 (7.8%) typical failures (P < 0.05). CONCLUSIONS: Shunts placed for hydrocephalus secondary to nonbacterial infections are complicated by significantly higher rates of malfunction. These patients are prone to develop distal abdominal pseudocysts and often require revision to low-resistance systems.


Assuntos
Anormalidades Cardiovasculares , Coccidioidomicose , Hidrocefalia de Pressão Normal , Hidrocefalia , Adulto , Idoso , Anormalidades Cardiovasculares/complicações , Anormalidades Cardiovasculares/cirurgia , Estudos de Casos e Controles , Derivações do Líquido Cefalorraquidiano/efeitos adversos , Coccidioidomicose/complicações , Feminino , Humanos , Hidrocefalia/microbiologia , Hidrocefalia/cirurgia , Hidrocefalia de Pressão Normal/cirurgia , Masculino , Pessoa de Meia-Idade , Próteses e Implantes/efeitos adversos , Reoperação/efeitos adversos , Estudos Retrospectivos , Derivação Ventriculoperitoneal/efeitos adversos
13.
J Investig Med High Impact Case Rep ; 10: 23247096211066392, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35543558

RESUMO

Coccidioidomycosis (CM) is an endemic fungal disease that is prevalent in the Southwestern United States, Mexico, and Central and South America. The majority of cases are asymptomatic. Symptomatic cases primarily present with pneumonic disease, varying in severity from mild to severe. In a minority, extrapulmonary disease is known to occur. These disseminated cases typically manifest as meningitis, osteomyelitis, synovitis, and integumentary. Coccidioidomycosis has been identified in nearly every part of the body, including the soft tissues and cartilaginous tissues of the oropharynx. Disseminated CM to the larynx specifically in the pediatric populations is rarely documented. This is a case of persistent stridor misdiagnosed as viral croup in a 9-month-old male with protracted disease. Herein, diagnosis and treatment of laryngeal mass found to be CM are defined with a salutatory outcome.


Assuntos
Coccidioidomicose , Crupe , Meningite , Criança , Coccidioidomicose/diagnóstico , Crupe/diagnóstico , Humanos , Lactente , Masculino , México
14.
Radiol Clin North Am ; 60(3): 409-427, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35534128

RESUMO

Histoplasmosis, blastomycosis, and coccidioidomycosis are endemic fungal infections in North America. Many infections are subclinical, and many symptomatic infections are mild. Pneumonia is the most common clinical manifestation. All can occur in immunocompetent and immunocompromised patients, with the latter at greater risk for disseminated and more severe disease. As with other acute respiratory illness, imaging can play a role in diagnosis. Knowledge of the acute and chronic imaging findings of endemic fungal infections is important for radiologists so that they can assist in establishing these often-elusive diagnoses, recognize normal evolution of imaging findings of infection, and identify complications.


Assuntos
Blastomicose , Coccidioidomicose , Histoplasmose , Pneumopatias Fúngicas , Blastomicose/diagnóstico por imagem , Blastomicose/epidemiologia , Coccidioidomicose/diagnóstico por imagem , Coccidioidomicose/epidemiologia , Histoplasmose/diagnóstico por imagem , Histoplasmose/epidemiologia , Humanos , Hospedeiro Imunocomprometido , Pneumopatias Fúngicas/diagnóstico por imagem , Pneumopatias Fúngicas/epidemiologia
15.
Eur J Clin Microbiol Infect Dis ; 41(6): 925-939, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35546215

RESUMO

Coccidioidomycosis is caused by the dimorphic fungi Coccidioides species which is endemic in the Western hemisphere. Reports on the characteristics of travel-related disseminated coccidioidomycosis in immunocompetent patients are rare, especially in non-endemic regions. The multifaceted symptoms of this condition present a diagnostic challenge to clinicians. This study aimed to review immunocompetent patients diagnosed with disseminated coccidioidomycosis in a tertiary hospital in Eastern China and other non-endemic areas, and to emphasize the importance of combining travel history with clinical manifestations and proper diagnostic examinations. This study retrospectively reviewed a case series of disseminated coccidioidomycosis diagnosed in an academic hospital in Eastern China. We conducted a global literature review of disseminated coccidioidomycosis in immunocompetent patients with travel history. We identified six patients in our case series and reviewed 42 cases in the literature. Travel history included Mexico, Arizona, California, and regions of low endemicity. Extrapulmonary sites of infection, which presented with diverse signs and symptoms, involved the skin and soft tissue, musculoskeletal system, lymph nodes, and central nervous system. Misdiagnoses and diagnostic delays were common. Next-generation sequencing substantially promoted precise diagnosis in our series. The overall prognosis for immunocompetent individuals was positive, mainly benefited from long-term azole therapies. The patients that succumbed had either central nervous system involvement or multiorgan dissemination. Progressive pneumonia with varied symptoms and travel history should alert healthcare professionals in non-endemic areas to consider the possibility of Coccidioides species infection. We recommend detailed history-taking and hypothesis-free detection of pathogens for cases with diagnostic delay.


Assuntos
Coccidioidomicose , Coccidioides/fisiologia , Coccidioidomicose/diagnóstico , Coccidioidomicose/tratamento farmacológico , Coccidioidomicose/epidemiologia , Diagnóstico Tardio , Humanos , Estudos Retrospectivos , Viagem , Doença Relacionada a Viagens
16.
J Investig Med High Impact Case Rep ; 10: 23247096221098339, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35567302

RESUMO

Coccidioidomycosis (CM) is a fungal infection endemic to the southwestern United States with a wide range of clinical presentations depending on the infected organ systems. Most infections are asymptomatic. Coccidioidomycosis causes a primary pulmonary infection and when symptoms occur, they most often resemble community-acquired pneumonia. One percent of cases disseminate, typically via hematogenous or lymphatic spread. It is in these cases that more severe symptoms may present and potentially overlap with those characteristics of other systemic illnesses. This is a case of CM disseminated to lymph nodes in a 24-year-old man with concomitant metastatic embryonal carcinoma. It is difficult to identify the primary etiology for many components of this patient's presentation, including diffuse lymphadenopathy and multiple pulmonary nodules. Furthermore, the relationship between these 2 concurrent disease processes is not entirely clear. Factors that may contribute include the well-known phenomenon of locus minoris resistentiae (LMR) or potentially a shared immune failure between infectious organisms and malignant cells.


Assuntos
Carcinoma Embrionário/complicações , Coccidioidomicose/complicações , Infestações por Pulgas/complicações , Infestações por Piolhos/complicações , Ftirápteros , Sifonápteros , Animais , Coccidioidomicose/diagnóstico , Humanos , Pulmão/patologia , Linfonodos/microbiologia , Linfonodos/parasitologia , Linfonodos/patologia , Masculino , Adulto Jovem
17.
Emerg Infect Dis ; 28(6): 1091-1100, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35608552

RESUMO

Demographic and clinical indicators have been described to support identification of coccidioidomycosis; however, the interplay of these conditions has not been explored in a clinical setting. In 2019, we enrolled 392 participants in a cross-sectional study for suspected coccidioidomycosis in emergency departments and inpatient units in Coccidioides-endemic regions. We aimed to develop a predictive model among participants with suspected coccidioidomycosis. We applied a least absolute shrinkage and selection operator to specific coccidioidomycosis predictors and developed univariable and multivariable logistic regression models. Univariable models identified elevated eosinophil count as a statistically significant predictive feature of coccidioidomycosis in both inpatient and outpatient settings. Our multivariable outpatient model also identified rash (adjusted odds ratio 9.74 [95% CI 1.03-92.24]; p = 0.047) as a predictor. Our results suggest preliminary support for developing a coccidioidomycosis prediction model for use in clinical settings.


Assuntos
Coccidioidomicose , Arizona/epidemiologia , Coccidioides , Coccidioidomicose/diagnóstico , Coccidioidomicose/epidemiologia , Estudos Transversais , Humanos
18.
Medicina (Kaunas) ; 58(5)2022 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-35630071

RESUMO

Coccidioidomycosis is an infectious disease caused by Coccidioides immitis or C. posadasii fungus. Humans usually get infected by inhaling spores risen from the soil. Although in 60 percent of cases symptoms are absent, remaining patients can develop various manifestations of the disease, from flu-like symptoms to severe dissemination or meningitis. In endemic regions (California, Arizona, Mexico, Central, and South America), pulmonary coccidioidomycosis causes 25% of community-acquired cases of pneumonia. We present the first registered case of pulmonary coccidioidomycosis in Lithuania. Clinical presentation, pathogenesis, treatment options, and diagnostic alternatives are discussed.


Assuntos
Coccidioidomicose , Coccidioides , Coccidioidomicose/diagnóstico , Coccidioidomicose/tratamento farmacológico , Coccidioidomicose/epidemiologia , Humanos , Lituânia , México
19.
J Investig Med High Impact Case Rep ; 10: 23247096221090840, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35426317

RESUMO

Infection of the thyroid gland with Coccidioides immitis is rare. We report a case with disseminated coccidiomycosis involving thyroid gland as a thyroid nodule. Although historical autopsy studies have indicated that coccidioidal involvement of the thyroid gland can infrequently occur as part of disseminated infection, to our knowledge, only less than 10 other cases have been reported. Optimal treatment duration and dosage of medication are uncertain in literature of this rare involvement of thyroid gland with coccidioidomycosis.


Assuntos
Coccidioides , Coccidioidomicose , Coccidioidomicose/complicações , Coccidioidomicose/diagnóstico , Coccidioidomicose/tratamento farmacológico , Humanos
20.
Mycoses ; 65(6): 599-612, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35484713

RESUMO

Biological sex, which comprises differences in host sex hormone homeostasis and immune responses, can have a substantial impact on the epidemiology of infectious diseases. Comprehensive data on sex distributions in invasive fungal diseases (IFDs) are lacking. In this review, we performed a literature search of in vitro/animal studies, clinical studies, systematic reviews and meta-analyses of invasive fungal infections. Females represented 51.2% of invasive candidiasis cases, mostly matching the proportions of females among the general population in the United States and Europe (>51%). In contrast, other IFDs were overrepresented in males, including invasive aspergillosis (51% males), mucormycosis (60%), cryptococcosis (74%), coccidioidomycosis (70%), histoplasmosis (61%) and blastomycosis (66%). Behavioural variations, as well as differences related to biological sex, may only in part explain these findings. Further investigations concerning the association between biological sex/gender and the pathogenesis of IFDs are warranted.


Assuntos
Actinomicose , Blastomicose , Coccidioidomicose , Criptococose , Histoplasmose , Infecções Fúngicas Invasivas , Pneumopatias Fúngicas , Mucormicose , Nocardiose , Feminino , Humanos , Infecções Fúngicas Invasivas/epidemiologia , Masculino , Fatores de Risco , Caracteres Sexuais , Estados Unidos
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