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    Top Questions in the Diagnosis and Treatment of Coccidioidomycosis.
    Open Forum Infect Dis 2017 12;4(4):ofx197. Epub 2017 Sep 12.
    The Valley Fever Center for Excellence and Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona.
    Revised and greatly expanded treatment guidelines for coccidioidomycosis were published last year by the Infectious Diseases Society of America. We have selected 4 questions that commonly arise in the management of patients suspected of this disease and for which there remain divided opinions. Read More

    Coccidioidomycosis in selected immunosuppressed hosts.
    Med Mycol 2018 Apr 13. Epub 2018 Apr 13.
    Division of Infectious Diseases, Sanford Health, Sioux Falls, South Dakota, USA.
    After contracting coccidioidomycosis, persons with impaired cellular immunity are more likely than healthy persons to have severe infection, disseminated infection, and higher mortality rates. In this brief review, we summarize the clinical manifestations, diagnosis, treatment, and prevention of coccidioidomycosis in persons infected with human immunodeficiency virus (HIV), recipients of solid organ or hematopoietic stem cell transplants, and recipients of biologic response modifiers. Among individuals infected with HIV, a diagnosis of acquired immunodeficiency syndrome (AIDS) and a CD4 T-lymphocyte count <250 cells/μl were associated with more severe coccidioidomycosis, whereas less severe disease occurred among those with undetectable HIV-RNA and higher CD4 T-lymphocyte counts, indicating that controlled HIV viremia and improved cellular immune status are important in limiting disease. Read More

    The Frozen Brain State of Cryptococcus gattii: A Globe-Trotting, Tropical, Neurotropic Fungus.
    Neurocrit Care 2018 Apr 16. Epub 2018 Apr 16.
    Neurosurgery Department, Kaiser Sacramento, 2025 Morse Avenue, Sacramento, CA, 95825, USA.
    Initially reported in tropical regions, Cryptococcus gattii infection is now diagnosed globally.

    Methods: case report; Literature review. Although initial reports described outbreaks of pulmonary and central nervous system (CNS) disease in tropical regions such as Australia and New Guinea, it is now clear that Cryptococcus gattii is a global, neurotropic pathogen. Read More

    The role of extracorporeal membrane oxygenation in severe pulmonary coccidioidomycosis.
    Heart Lung 2018 Apr 2. Epub 2018 Apr 2.
    Critical Care Medicine, Regional Medical Center of San Jose, 225 North Jackson Ave, San Jose, CA 95116, USA.
    Background: Severe coccidioidal pneumonia with acute respiratory distress syndrome (ARDS) is associated with high mortality. Extracorporeal membrane oxygenation (ECMO) has been applied successfully to other severe fungal pneumonia associated with ARDS. We review our experience with the use of ECMO in severe coccidioidal ARDS. Read More

    Pediatric Coccidioidomycosis: Case Series from a California Pediatric Infectious Diseases Clinic.
    Pediatr Infect Dis J 2018 Apr 9. Epub 2018 Apr 9.
    Background: Coccidioidomycosis is not as well described in the pediatric population as it is in the adult population. We describe clinical findings, diagnosis, and management of coccidioidomycosis in 108 pediatric patients seen in an outpatient clinic in the California Central Valley, an area endemic for coccidioidomycosis.

    Methods: We reviewed medical records of a convenience sample of pediatric patients (≤17 years of age) diagnosed with coccidioidomycosis who visited an infectious diseases clinic in Madera, CA during January 1-October 1, 2012. Read More

    Myeloid differentiation factor 88 (MyD88) and IL-1R1 signaling contribute to resistance to .
    Infect Immun 2018 Apr 2. Epub 2018 Apr 2.
    Department of Medicine, UC San Diego School of Medicine VA Healthcare, San Diego, CA
    Rodents are a natural host for the dimorphic pathogenic fungi and , and mice are a good model for human infection. Humans and rodents both express Dectin-1 and TLR2 on myeloid cells and those receptors collaborate to maximize the cytokine/chemokine responses to spherules (the tissue form of the fungi), and to formalin killed spherules (FKS). We showed that Dectin-1 is necessary for resistance to pulmonary coccidioidomycosis, but the importance of TLR2 is uncertain. Read More

    Detection of Coccidioides posadasii from xerophytic environments in Venezuela reveals risk of naturally acquired coccidioidomycosis infections.
    Emerg Microbes Infect 2018 Mar 29;7(1):46. Epub 2018 Mar 29.
    Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, 86011, USA.
    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. Read More

    Testing for Coccidioidomycosis among Community-Acquired Pneumonia Patients, Southern California, USA.
    Emerg Infect Dis 2018 Apr;24(4):779-781
    We conducted a cohort study to identify characteristics associated with testing for, and testing positive for, coccidioidomycosis among patients with community-acquired pneumonia in southern California, USA. Limited and delayed testing probably leads to underdiagnosis among non-Hispanic black, Filipino, or Hispanic patients and among high-risk groups, including persons in whom antimicrobial drug therapy has failed. Read More

    Skinmed 2018 1;16(1):51-53. Epub 2018 Feb 1.
    Medical Dermatology Specialists, Phoenix, AZ;
    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. Read More

    Direct detection of Coccidioides from Arizona soils using CocciENV, a highly sensitive and specific real-time PCR assay.
    Med Mycol 2018 Mar 8. Epub 2018 Mar 8.
    Pathogen Genomics Division, Translational Genomics Research Institute North, Flagstaff, Arizona.
    Coccidioides immitis and Coccidioides posadasii are soil fungi endemic to desert regions of the southwestern United States, and the causative agents of valley fever, or coccidioidomycosis. Studies have shown that the distribution of Coccidioides in soils is sporadic and cannot be explained by soil characteristics alone, suggesting that biotic and other abiotic factors should be examined. However, tools to reliably and robustly screen the large number of soils needed to investigate these potential associations have not been available. Read More

    Coccidioidomycosis Outbreaks, United States and Worldwide, 1940-2015.
    Emerg Infect Dis 2018 Mar;24(3):417-423
    Coccidioidomycosis causes substantial illness and death in the United States each year. Although most cases are sporadic, outbreaks provide insight into the clinical and environmental features of coccidioidomycosis, high-risk activities, and the geographic range of Coccidioides fungi. We identified reports published in English of 47 coccidioidomycosis outbreaks worldwide that resulted in 1,464 cases during 1940-2015. Read More

    Imported endemic mycoses in Spain: Evolution of hospitalized cases, clinical characteristics and correlation with migratory movements, 1997-2014.
    PLoS Negl Trop Dis 2018 Feb 15;12(2):e0006245. Epub 2018 Feb 15.
    Tropical Medicine Unit, Infectious Diseases Department. PROSICS Barcelona (International Health Program of the Catalan Health Institute), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
    Endemic mycoses are systemic fungal infections. Histoplasmosis is endemic in all temperate areas of the world; coccidioidomycosis and paracoccidioidomycosis are only present in the American continent. These pathogens are not present in Spain, but in the last years there has been an increase of reported cases due to migration and temporary movements. Read More

    The Novel Fungal Cyp51 Inhibitor VT-1598 Is Efficacious in Experimental Models of Central Nervous System Coccidioidomycosis Caused by Coccidioides posadasii and Coccidioides immitis.
    Antimicrob Agents Chemother 2018 Apr 27;62(4). Epub 2018 Mar 27.
    University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
    Coccidioidal meningitis can cause significant morbidity, and lifelong antifungal therapy is often required. VT-1598 is a fungus-specific Cyp51 inhibitor that has potent activity against species. We evaluated the efficacy of VT-1598 in murine models of central nervous system coccidioidomycosis caused by and Infection was introduced via intracranial inoculation, and therapy began 48 h postinoculation. Read More

    Lung health in era of climate change and dust storms.
    Environ Res 2018 May 6;163:36-42. Epub 2018 Feb 6.
    Division of Pulmonary and Critical Care, University of Miami, Miami, FL, United States; Miami VA Healthcare System, Miami, FL, United States. Electronic address:
    Dust storms are strong winds which lead to particle exposure over extensive areas. These storms influence air quality on both a local and global scale which lead to both short and long-term effects. The frequency of dust storms has been on the rise during the last decade. Read More

    Coccidioidomycosis: Imported and possible domestic cases in China: A case report and review, 1958-2017.
    Mycoses 2018 Jan 31. Epub 2018 Jan 31.
    Department of Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.
    We report a case of imported pulmonary coccidioidomycosis caused by Coccidioides posadasii in a patient who was misdiagnosed as tuberculosis and mistreated with antituberculosis medications for 18 months. The symptoms were not relieved until antifungal treatment was started. An extensive review of the coccidioidomycosis cases occurring in China reveals 38 cases, 16 of which had no associated history of travel to any traditional endemic areas. Read More

    The Quest for a Vaccine Against Coccidioidomycosis: A Neglected Disease of the Americas.
    J Fungi (Basel) 2016 Dec 16;2(4). Epub 2016 Dec 16.
    Departments of Pathology and Medicine, University of California, San Diego, School of Medicine, San Diego, CA 92161, USA.
    Coccidioidomycosis (Valley Fever) is a disease caused by inhalation of spp. This neglected disease has substantial public health impact despite its geographic restriction to desert areas of the southwestern U.S. Read More

    Fluctuating hypercalcaemia caused by cavitary pulmonary infection.
    BMJ Case Rep 2018 Jan 26;2018. Epub 2018 Jan 26.
    Department of Respiratory Medicine, Mercy University Hospital, Cork, Munster, Ireland.
    Hypercalcaemia occurs in many granulomatous diseases. Among them, sarcoidosis and tuberculosis are the most common causes. Other causes include berylliosis, coccidioidomycosis, histoplasmosis, Crohn's disease, silicone-induced granulomas, cat-scratch disease, Wegener's granulomatosis and pneumonia. Read More

    Combined Endosonography Reduces Time to Diagnose Pulmonary Coccidioidomycosis.
    J Bronchology Interv Pulmonol 2018 Apr;25(2):152-155
    Division of Pulmonary Critical Care Medicine, University of California San Francisco, Fresno, CA.
    Coccidioidomycosis causes significant morbidity in endemic areas. In the absence of sensitive diagnostic serologic testing, clinicians have increasingly relied on lung and lymph node biopsies for diagnosis. Recently, endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has been shown to be an excellent sampling method for the diagnosis and staging of lung cancers, especially when combined with endoscopic ultrasound guided fine needle aspiration (EUS-FNA). Read More

    Liposomal Amphotericin B as Monotherapy in Relapsed Coccidioidal Meningitis.
    Mycopathologia 2018 Jan 16. Epub 2018 Jan 16.
    Department of Internal Medicine, Division of Infectious Diseases, University of California Davis Medical Center, 4150 V Street, Suite G500, Sacramento, CA, 95817, USA.
    Coccidioidal meningitis remains a difficult clinical problem, and despite life-long therapy with triazole antifungals, relapses of disease and medication intolerance occur necessitating salvage treatment. We report two patients with recurrent coccidioidal meningitis who improved following a 2-week course of liposomal amphotericin B monotherapy and discuss potential advantages of this treatment option. Read More

    Prevalence, healthcare resource utilization and overall burden of fungal meningitis in the United States.
    J Med Microbiol 2018 Feb 15;67(2):215-227. Epub 2017 Dec 15.
    1​Department of Neurosurgery, Duke University Medical Center, NC, USA.
    Purpose: Previous epidemiological and cost studies of fungal meningitis have largely focused on single pathogens, leading to a poor understanding of the disease in general. We studied the largest and most diverse group of fungal meningitis patients to date, over the longest follow-up period, to examine the broad impact on resource utilization within the United States.

    Methodology: The Truven Health Analytics MarketScan database was used to identify patients with a fungal meningitis diagnosis in the United States between 2000 and 2012. Read More

    Testing for coccidioidomycosis in emergency departments in Arizona.
    Med Mycol 2017 Dec 8. Epub 2017 Dec 8.
    Arizona Department of Health Services, Phoenix, AZ, USA.
    Testing practices for coccidioidomycosis in the emergency department are poorly understood. We described characteristics of patients tested for coccidioidomycosis in emergency departments in Arizona and examined coccidioidomycosis testing among community-acquired pneumonia (CAP) patients. Emergency department visit records for patients tested for coccidioidomycosis and CAP patients were extracted from the Arizona hospital discharge database. Read More

    Multicenter Clinical Validation of a Cartridge-Based Real-Time PCR System for Detection of Coccidioides spp. in Lower Respiratory Specimens.
    J Clin Microbiol 2018 Feb 24;56(2). Epub 2018 Jan 24.
    Laboratory Sciences of Arizona/Sonora Quest Laboratories, Tempe, Arizona, USA.
    Available methods for the diagnosis of coccidioidomycosis have significant shortcomings relative to accuracy and timeliness. We retrospectively and prospectively evaluated the diagnostic performance and reproducibility of a new cartridge-based real-time PCR assay for spp. directly in lower respiratory secretions and compared them to today's "gold standard," fungal culture. Read More

    Recommendations for the management of pulmonary fungal infections in patients with rheumatoid arthritis.
    Clin Exp Rheumatol 2017 Nov-Dec;35(6):1018-1028. Epub 2017 Nov 28.
    Rheumatology Unit, L. Sacco University Hospital, Milan, Italy.
    Often life-threatening pulmonary fungal infections (PFIs) can occur in patients with rheumatoid arthritis (RA) receiving disease-modifying anti-rheumatic drugs (DMARDs). Most of the data concerning PFIs in RA patients come from case reports and retrospective case series. Of the ve most widely described PFIs, Pneumocystis jirovecii pneumonia (PJP) has rarely been seen outside Japan, pulmonary cryptococcosis has been diagnosed in only a small number of patients worldwide, pulmonary coccidioidomycosis has almost only been observed in endemic areas, the limited number of cases of pulmonary histoplasmosis have mainly occurred in the USA, and the rare cases of invasive pulmonary aspergillosis have only been encountered in leukopenic patients. Read More

    Proteogenomic Re-Annotation of Coccidioides posadasii Strain Silveira.
    Proteomics 2018 Jan 14;18(1). Epub 2017 Dec 14.
    School of Life Sciences, Mayo Clinic Collaborative Research Building, Arizona State University, Scottsdale, AZ, USA.
    The aims of this study are to provide protein-based evidence upon which to reannotate the genome of Coccidiodes posadasii, one of two closely related species of Coccidioides, a dimorphic fungal pathogen that causes coccidioidomycosis, also called Valley fever. Proteins present in lysates and filtrates of in vitro grown mycelia and parasitic phase spherules from C. posadasii strain Silveira are analyzed using a GeLC-MS/MS method. Read More

    Relating coccidioidomycosis (valley fever) incidence to soil moisture conditions.
    Geohealth 2017 Apr 25;1:51-63. Epub 2017 Mar 25.
    USDA-ARS-Hydrology and Remote Sensing Laboratory, Beltsville, Maryland, USA.
    Coccidioidomycosis (also called Valley fever) is caused by a soilborne fungus, spp. in arid regions of the southwestern United States. Though some who develop infections from this fungus remain asymptomatic, others develop respiratory disease as a consequence. Read More

    A point-source outbreak of Coccidioidomycosis among a highway construction crew.
    J Occup Environ Hyg 2018 Jan;15(1):57-62
    a School of Public Health, University of California , Berkeley , California.
    Coccidioidomycosis is an infection caused by inhaling spores of the soil fungus Coccidioides immitis (hereafter termed Cocci). Cocci is endemic in certain areas of California. When soil containing the fungus is disturbed, as during earth-moving activities, respirable Cocci spores can become airborne and be inhaled by persons in the vicinity. Read More

    Coccidioidomycosis, immunoglobulin deficiency: safety challenges with CAR T cells therapy for relapsed lymphoma.
    Immunotherapy 2017 Oct;9(13):1061-1066
    Department of Medicine, Division of Hematology, Oncology, Blood and marrow transplantation, University of Arizona, Tucson, AZ 85724, USA.
    Treatment of patients with relapsed or refractory lymphoma may require allogenic hematopoietic stem cell transplant (HSCT), but treatment of post-transplant relapse disease remains very challenging. Donor lymphocyte infusion and blinatumomab have been used with limited success for the treatment of relapse. Initial data on donor-derived CAR T cells has shown this modality to be safe and highly effective in various hematological malignancies. Read More

    Coccidioidomycosis in an Indoor-housed Rhesus Macaque ().
    Comp Med 2017 Oct;67(5):452-455
    Integrated Biological Platform Sciences, GlaxoSmithKline Research and Development, Collegeville, Pennsylvania;, Email:
    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. Read More

    Diagnostic Imaging and Invasive Fungal Diseases in Children.
    J Pediatric Infect Dis Soc 2017 Sep;6(suppl_1):S22-S31
    Transplantation-Oncology Infectious Diseases Program and Departments of Medicine, Pediatrics, Microbiology and Immunology, Weill Cornell Medicine of Cornell University and New York Presbyterian Hospital.
    Invasive fungal disease (IFD) is a life-threatening condition, especially in immunocompromised children. The role of diagnostic imaging in children at risk for an IFD is multifactorial, including initially detecting it, evaluating for dissemination of infection beyond the primary site of disease, monitoring the response to antifungal therapy, and assessing for potential relapse. The objective of this review was to synthesize the published literature relevant to the use of various imaging modalities for the diagnosis and management of IFD in children. Read More

    Immune Reconstitution Inflammatory Syndrome in Patients with AIDS and Disseminated Coccidioidomycosis: A Case Series and Review of the Literature.
    J Int Assoc Provid AIDS Care 2017 Nov/Dec;16(6):540-545. Epub 2017 Sep 14.
    1 Division of Infectious Diseases, University of California San Francisco, Fresno Medical Education Program, Fresno, CA, USA.
    Coccidioidomycosis causes substantial morbidity and mortality in endemic areas, and dissemination is frequent in patients with impaired cellular immunity such as AIDS. Immune reconstitution inflammatory syndrome (IRIS) is paradoxical clinical worsening after initiation of antiretroviral therapy (ART) in a patient with HIV and a simultaneous opportunistic infection (OI). Immune reconstitution inflammatory syndrome has been well described for a host of mycobacterial, viral, and fungal OIs and malignancies such as Kaposi sarcoma. Read More

    A 62-Year-Old Woman With Wheezing, Respiratory Failure, and an Abnormal CT Scan.
    Chest 2017 09;152(3):e73-e76
    Department of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
    Case Presentation: A previously healthy 62-year-old woman was transferred to the ICU from the medical ward with acute bronchospastic respiratory failure requiring intubation and mechanical ventilation. Four weeks before, the patient was vacationing in Arizona and acquired a mildly productive cough as well as mild dyspnea. She presented to an urgent care facility and was diagnosed with community-acquired pneumonia. Read More

    Favorable Outcome in Coccidioides Endophthalmitis-A Combined Medical and Surgical Treatment Approach.
    Cornea 2017 Nov;36(11):1423-1425
    *Department of Ophthalmology and Vision Science, University of California Davis Medical Center, Sacramento, CA; †Department of Internal Medicine, Division of Infectious Diseases, University of California Davis Medical Center, Sacramento, CA; and ‡Department of Medical Microbiology and Immunology, University of California Davis, Davis, CA.
    Purpose: To describe a case of Coccidioides endophthalmitis that resulted in a favorable visual outcome after a combined medical and surgical approach.

    Methods: A 33-year-old previously healthy woman was referred for evaluation of dyspnea and left-sided vision loss, which began 3 months before, after a trip to Nevada. She was found to have a pulmonary cavitary lesion and fluffy white material in the anterior chamber. Read More

    Coccidioidomycosis Involving Lungs and Skin: A Mimicker of Metastatic Disease.
    Am J Dermatopathol 2018 Mar;40(3):e41-e43
    Departments of Pathology, and.
    Coccidioidomycosis is the major systemic mycoses, considered to be 1 of the most infectious fungal diseases. In symptomatic patients, the most common manifestation is pulmonary disease, but many other organs can be affected. Disseminated disease occurs in 1%-5% of all patients affected by coccidioidomycosis and can affect any organ, with the skin, central nervous system, and musculoskeletal system being reported as the most prevalent. Read More

    Enucleation or exenteration in two dogs with previous parotid duct transposition: parotid duct ligation versus reverse parotid duct transposition.
    Vet Ophthalmol 2017 Aug 27. Epub 2017 Aug 27.
    Veterinary Specialty Center of Tucson, Tucson, AZ, USA.
    Two dogs with previous parotid duct transpositions presented with unrelated ocular disease. In both cases, ophthalmic examination revealed the need for enucleation or exenteration. In case 1, systemic coccidioidomycosis was diagnosed with panuveitis and secondary glaucoma of the left eye. Read More

    Spinal Coccidioidomycosis: A Current Review of Diagnosis and Management.
    World Neurosurg 2017 Dec 24;108:69-75. Epub 2017 Aug 24.
    Department of Neurosurgery, Barrow Neurological Institute, Saint Joseph's Hospital and Medical Center, Phoenix, Arizona, USA. Electronic address:
    Objective: Coccidioidomycosis is an invasive fungal disease that may present with extrathoracic dissemination. Patients with spinal coccidioidomycosis require unique medical and surgical management. We review the risk factors and clinical presentations, discuss the indications for surgical intervention, and evaluate outcomes and complications after medical and surgical management. Read More

    Opportunistic Invasive Mycoses in AIDS: Cryptococcosis, Histoplasmosis, Coccidiodomycosis, and Talaromycosis.
    Curr Infect Dis Rep 2017 Aug 22;19(10):36. Epub 2017 Aug 22.
    University of Colorado Denver, Anschutz Medical Campus, Denver, CO, USA.
    Purpose Of Review: The goal of this review is to provide an update on the epidemiology, diagnosis, and treatment of opportunistic fungal infections in patients with human immunodeficiency virus (HIV) infection including Cryptococcus spp., Histoplasma spp., Coccidioides spp. Read More

    Recurrence of cutaneous coccidioidomycosis 6 years after valley fever: A case presentation and literature review.
    Diagn Microbiol Infect Dis 2017 Nov 8;89(3):218-221. Epub 2017 Jul 8.
    Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Department of Medicine, Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, Indiana, USA. Electronic address:
    Coccidioidomycosis is usually acquired by inhalation of spores of Coccidioides immitis and C. posadasii. The disease ranges from a self-limited acute pneumonia (Valley Fever) to a disseminated disease. Read More

    Diagnosis and Management of Coccidioidomycosis.
    Clin Chest Med 2017 Sep 3;38(3):417-433. Epub 2017 Jun 3.
    Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Arizona College of Medicine - Tucson, 1501 North Campbell Avenue, Tucson, AZ 85724, USA. Electronic address:
    Coccidioidomycosis is a leading cause of community-acquired pneumonia within its traditional endemic zone in the Southwestern United States and portions of Mexico and Central and South America. Its incidence has increased dramatically within the endemic region; its presence outside of the region, facilitated by a mobile society, is also now substantial. Although only a fraction of the incident disease progresses beyond subclinical illness, this proportion is large in absolute terms and causes substantial disease burden. Read More

    Notes from the Field: Increase in Coccidioidomycosis - California, 2016.
    MMWR Morb Mortal Wkly Rep 2017 Aug 11;66(31):833-834. Epub 2017 Aug 11.
    Coccidioidomycosis, or Valley Fever, is an infectious disease caused by inhalation of Coccidioides spp. spores (1). This soil-dwelling fungus is endemic in the southwestern United States, with most (97%) U. Read More

    Diagnosis of coccidioidomycosis in a non-endemic area: Inference of the probable geographic area of an infection.
    Rev Iberoam Micol 2017 Oct - Dec;34(4):237-240. Epub 2017 Aug 5.
    Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria No. 3000, México, Cd. Mx. 04510, Mexico. Electronic address:
    Background: Coccidioidomycosis is one of the most important endemic mycoses in Northern Mexico. However, diagnosing this disease can be challenging, particularly in patients who do not reside in endemic areas.

    Case Report: The case of a Mexican HIV+ patient who developed fever, general malaise, a severe cough, and dyspnea during a stay in Acapulco, Guerrero, Mexico, is presented. Read More

    Arthroconidia in lung tissue: an unusual histopathological finding in pulmonary coccidioidomycosis.
    Hum Pathol 2018 Jan 1;71:55-59. Epub 2017 Aug 1.
    Beth Israel Deaconess Medical Center, Department of Pathology, Boston, MA 02215; Harvard Medical School, Boston, MA 02215. Electronic address:
    Coccidioides immitis/posadasii presents in mycelial form with branching hyphae and arthroconidia when cultured in the laboratory. On histopathology, the presence of endospore-containing spherules is considered diagnostic of coccidioidomycosis. Here we report an unusual case of coccidioidomycosis with hyphae and arthroconidia in pulmonary tissue sections. Read More

    Disseminated coccidioidomycosis with molluscum-like lesions, diffuse lymphadenopathy, and splenomegaly in an immunocompetent patient.
    Int Med Case Rep J 2017 20;10:251-254. Epub 2017 Jul 20.
    Texas Tech University Health Sciences Center.
    Coccidioidomycosis is caused by a dimorphic fungus species endemic to the arid and semi-arid regions of the Americas. The species have a terranean habitat producing a primary pulmonary infection by inhalation of arthroconidia. We describe a case of extrapulmonary coccidioidomycosis presenting with extensive lymphadenopathy, splenomegaly, and florid cutaneous lesions. Read More

    Coccidioidomycosis A Cause of Sarcoidosis.
    Open Forum Infect Dis 2017 10;4(3):ofw117. Epub 2017 Jul 10.
    School of Medicine, University of Arizona School of Medicine-Phoenix, Phoenix, Arizona.
    Background: Sarcoidosis is a granulomatous disease of unknown etiology and coccidioidomycosis is a granulomatous fungal infection endemic to the southwestern United States. Clinical observations on patients with sarcoidosis and coccidioidomycosis simultaneously led to the hypothesis that sarcoidosis can be caused by the fungus .

    Methods: Two patients with sarcoidosis and coccidioidomycosis were studied, one prospectively (ie, a patient with sarcoidosis was predicted to develop coccidioidomycosis) and the other retrospectively (ie, a patient with coccidioidomycosis develops sarcoidosis). Read More

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