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    Bone Scan, PET-CT, and MRI in Disseminated Coccidioidomycosis.
    Clin Nucl Med 2017 Feb 3. Epub 2017 Feb 3.
    From the Naval Medical Center San Diego, San Diego, CA.
    Coccidioidomycosis (valley fever) is a systemic fungal infection resulting from inhalation of the Coccidioides immitis or posadasii spores. In many cases, infection causes a self-limited community-acquired pneumonia; however, in patients with risk factors, such as immunosuppression or African or Pacific Island ancestry, significant morbidity and mortality from disseminated disease may occur. Presented here are comparative images using Tc-MDP bone scan, F-FDG PET/CT, and MRI. Read More

    Opportunistic Fungal Infections in Critical Care Units.
    Crit Care Nurs Clin North Am 2017 Mar 14;29(1):67-79. Epub 2016 Dec 14.
    Nursing Department, School of Nursing, Louisiana State University Health Sciences Center, Louisiana Center for Promotion of Optimal Health Outcomes: A JBI Center of Excellence, 1900 Gravier Street, 4B17, New Orleans, LA 70112, USA.
    Fungal infections are rare compared with bacterial infections, but they are on the increase in critical care units. Diagnosis can be difficult, resulting in increased mortality. Immunocompromised patients are at higher risk for fungal infections, including organ transplant, oncology, and HIV/AIDS patients. Read More

    Peritoneal and genital coccidioidomycosis in an otherwise healthy Danish female: a case report.
    BMC Infect Dis 2017 Jan 31;17(1):105. Epub 2017 Jan 31.
    Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark.
    Background: Coccidioidomycosis is a fungal infection that usually presents as a primary lung infection. The fungus is endemic to the Southwest United States of America, northern Mexico and parts of Central and South America the infection is rare outside these areas. However, some patients develop disseminated infection that can lie dormant for several years and can present itself in travelers. Read More

    Donor-Related Coccidioidomycosis Transmitted Through Left Liver Transplant to a Child Recipient in a Non-Endemic Area.
    Pediatr Infect Dis J 2017 Jan 26. Epub 2017 Jan 26.
    1 Service d'Hépatologie, Gastroentérologie et Nutrition Pédiatriques, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Bron, France 2 Service de Pathologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France 3 Institut de Parasitologie et Mycologie Médicale, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France 4 Service d'Urgences et de Réanimation Pédiatrique, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Bron, France 5 Service de Chirurgie Pédiatrique Uro-viscérale et Transplantation, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Bron, France 6 Unité de Transplantation Hépatique, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France 7 Université Claude Bernard Lyon 1, Lyon, France.
    This first observation of donor-transmitted cocciodioidomycosis to a pediatric liver transplant recipient underlines a rare condition in transplanted patients in a non-endemic area. Moreover, this transmission was observed following a liver split, the patient being contaminated by the left liver while the right liver recipient was not. Read More

    Risk Factors for Disseminated Coccidioidomycosis, United States.
    Emerg Infect Dis 2017 Feb;23(2)
    Of 150,000 new coccidioidomycosis infections that occur annually in the United States, ≈1% disseminate; one third of those cases are fatal. Immunocompromised hosts have higher rates of dissemination. We identified 8 patients with disseminated coccidioidomycosis who had defects in the interleukin-12/interferon-γ and STAT3 axes, indicating that these are critical host defense pathways. Read More

    Large-Scale Land Development, Fugitive Dust, and Increased Coccidioidomycosis Incidence in the Antelope Valley of California, 1999-2014.
    Mycopathologia 2017 Jan 13. Epub 2017 Jan 13.
    Department of Biology, California State University Bakersfield (CSUB), 9001 Stockdale Highway, Bakersfield, CA, 93311-1022, USA.
    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. Read More

    Disseminated coccidioidomycosis presenting with intramedullary spinal cord abscesses: Management challenges.
    Med Mycol Case Rep 2017 Mar 2;15:1-4. Epub 2016 Dec 2.
    Department of Medicine, Divison of Allergy and Infectious Diseases, Harborview Medical Center, Seattle, WA, USA.
    Coccidioides species are endemic to the southwestern United States and typically cause a mild or asymptomatic primary infection. In some instances, infection can disseminate and involve the central nervous system with meningitis being the most common manifestation. Non-osseous spinal cord involvement is exceedingly rare. Read More

    J Clin Microbiol 2017 Jan 4. Epub 2017 Jan 4.
    Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona U.S.A.
    Background: Coccidioidomycosis is a common cause of community-acquired pneumonia in endemic areas of the southwestern United States. Clinical presentations range from self-limited disease to severe, disseminated disease. As such, early and accurate diagnosis is essential to ensure appropriate treatment and monitoring. Read More

    Intrathecal Amphotericin B: A 60-Year Experience in Treating Coccidioidal Meningitis.
    Clin Infect Dis 2016 Dec 7. Epub 2016 Dec 7.
    Medicine, Kern Medical, Bakersfield, California; and.
    Coccidioidal meningitis (CM) is a devastating complication of coccidioidomycosis. Since the late 1950s, intrathecal (IT) amphotericin B deoxycholate (AmBd) has been successfully used to treat and often cure this disease, reducing mortality rates from 100% to approximately 30%. The introduction of azoles further revolutionized the treatment of coccidioidal infections. Read More

    First reported case of peroneal tenosynovitis caused by Coccidioides immitis successfully treated with fluconazole.
    BMJ Case Rep 2016 Nov 30;2016. Epub 2016 Nov 30.
    Infectious Disease Division, Department of Medicine, University of Arizona, Tucson, Arizona, USA.
    Coccidioidomycosis is an insidious infection caused by Coccidioides spp (C. immitis and C. posadasii). Read More

    AST to ALT Ratio is elevated in disseminated histoplasmosis as compared to localized pulmonary disease and other endemic mycoses.
    Med Mycol 2016 Oct 14. Epub 2016 Oct 14.
    Rush University Medical Center, Chicago, Illinois, USA.
    Severe pulmonary or disseminated histoplasmosis often necessitates presumptive antifungal treatment while awaiting definitive diagnosis. Histoplasma antigen assays have improved sensitivity but results may lag up to 7 days. In order to increase diagnostic certainty, "soft clues" may be looked for in laboratory and radiologic data, such as elevated alkaline phosphatase or ferritin levels and findings of mediastinal adenopathy or hepatosplenomegaly. Read More

    The effect of climate change on skin disease in North America.
    J Am Acad Dermatol 2017 Jan 11;76(1):140-147. Epub 2016 Oct 11.
    Dermatology, University of Pennsylvania Hospital, Philadelphia, Pennsylvania. Electronic address:
    Global temperatures continue to rise, reaching new records almost every year this decade. Although the causes are debated, climate change is a reality. Consequences of climate change include melting of the arctic ice cap, rising of sea levels, changes in precipitation patterns, and increased severe weather events. Read More

    Coccidioidomycosis: Surgical Issues and Implications.
    Surg Infect (Larchmt) 2016 Dec 14;17(6):645-655. Epub 2016 Oct 14.
    1 Department of Surgery, Stanford University , Stanford, California.
    Background: Coccidioidomycosis, commonly called "valley fever," "San Joaquin fever," "desert fever," or "desert rheumatism," is a multi-system illness caused by infection with Coccidioides fungi (C. immitis or C. posadasii). Read More

    The habitat of Coccidioides spp. and the role of animals as reservoirs and disseminators in nature.
    BMC Infect Dis 2016 Oct 10;16(1):550. Epub 2016 Oct 10.
    Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria No. 3000, Coyoacán, 04510, México Cd.Mx., Mexico.
    Background: Coccidioidomycosis, a potentially fatal fungal infection, is considered an emergent mycotic disease because of the increased incidence of fungal infections registered over recent years. Infection occurs through the inhalation of arthroconidia from two main species of Coccidioides: Coccidioides immitis and C. posadasii, which are both endemic to arid and semi-arid regions of North America. Read More

    Clinicopathologic and Histopathologic Renal Abnormalities in Dogs with Coccidioidomycosis.
    J Vet Intern Med 2016 Sep;30(5):1667-1671
    The Department of Medicine & Epidemiology, University of California, Davis, Davis, CA.
    Background: We observed evidence of protein-losing nephropathy in some dogs with coccidioidomycosis, suggestive of immune complex glomerulonephritis (ICGN). The goal of this study was to understand the prevalence of renal histopathologic lesions and proteinuria in dogs with coccidioidomycosis.

    Hypothesis: Biochemical and histopathological evidence of glomerular lesions is present in dogs with coccidioidomycosis. Read More

    Hospitalized burden and outcomes of coccidioidomycosis: A nationwide analysis, 2005-2012.
    Med Mycol 2016 Oct 4. Epub 2016 Oct 4.
    Comprehensive Digestive Institute of Nevada and Roseman University College of Medicine, Las Vegas, Nevada, USA.
    The incidence of coccidioidomycosis (CM) infection has increased over the last 20 years. We investigated recent trends of CM-associated hospitalization in the United States. patients with CM-associated hospitalization were identified from the Nationwide Inpatient Sample, 2005-2012. Read More

    Effect of Geography on the Analysis of Coccidioidomycosis-Associated Deaths, United States.
    Emerg Infect Dis 2016 Oct;22(10):1821-3
    Because coccidioidomycosis death rates vary by region, we reanalyzed coccidioidomycosis-associated mortality in the United States by race/ethnicity, then limited analysis to Arizona and California. Coccidioidomycosis-associated deaths were shown to increase among African-Americans but decrease among Native Americans and Hispanics. Separately, in a Native American cohort, diabetes co-varied with coccidioidomycosis-associated death. Read More

    Treatment considerations in pulmonary coccidioidomycosis.
    Expert Rev Respir Med 2016 Oct 22;10(10):1079-91. Epub 2016 Sep 22.
    a Division of Infectious Diseases , Mayo Clinic Hospital , Phoenix , AZ , USA.
    Introduction: Coccidioidomycosis is an endemic fungal infection caused by the soil-dwelling fungi, Coccidioides species. Coccidioidal infections may be asymptomatic in up to two-thirds of infected persons. Pulmonary coccidioidomycosis is the most common form of symptomatic infection. Read More

    Preclinical identification of vaccine induced protective correlates in human leukocyte antigen expressing transgenic mice infected with Coccidioides posadasii.
    Vaccine 2016 Oct 9;34(44):5336-5343. Epub 2016 Sep 9.
    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. Electronic address:
    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. Read More

    Rare Dysuria: Prostatic Abscess due to Disseminated Coccidioidomycosis.
    Urol Case Rep 2016 Nov 27;9:12-4. Epub 2016 Aug 27.
    UCLA Medical Center, 757 Westwood Blvd, Los Angeles, CA 90095, USA.
    We present a case of disseminated coccidioidomycosis with formation of a prostatic abscess in a 28-year-old diabetic male. Though rare, Coccidiodes prostatitis should be included in the differential for patients who have spent time in endemic areas and present with prostatitis or other genitourinary tract symptoms, especially in the setting of immunocompromise. The small number of Coccidiodes prostatitis cases described in the literature previously are reviewed, along with a wider discussion of coccidioidomycosis. Read More

    Mortality From Fungal Diseases in the US Air Force From 1970 to 2013.
    US Army Med Dep J 2016 Oct-Dec(3-16):38-41
    New York State Department of Health, Albany, New York.
    We review a unique set of documents, death certificates, catalogued in the US Air Force Mortality Registry, which tracks deaths for current and retired Air Force service members. We screened the records for all deaths caused by fungal diseases between 1970 and 2013. There were 216 deaths caused by a variety of diseases such as aspergillosis, blastomycosis, candidiasis, coccidioidomycosis, cryptococcosis, histoplasmosis, mucormycosis, pneumocystosis, sporotrichosis, and zygomycosis. Read More

    Executive Summary: 2016 Infectious Diseases Society of America (IDSA) Clinical Practice Guideline for the Treatment of Coccidioidomycosis.
    Clin Infect Dis 2016 Sep;63(6):717-22
    Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona.
    It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. Infectious Diseases Society of America considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances. Read More

    Cerebrospinal Fluid (1,3)-Beta-d-Glucan Testing Is Useful in Diagnosis of Coccidioidal Meningitis.
    J Clin Microbiol 2016 Nov 24;54(11):2707-2710. Epub 2016 Aug 24.
    Stanford University Medical School and California Institute Medical Research, San Jose, California, USA.
    Diagnosing coccidioidal meningitis (CM) can be problematic owing to its infrequency and/or a delay in the positivity of a cerebrospinal fluid (CSF) culture or CSF antibody, particularly if the primary coccidioidal infection is unrecognized. We tested 37 CSF specimens, 26 from patients with confirmed CM and 11 from patients with suspected microbial meningitis without fungal diagnosis, for (1,3)-beta-glucan (BG). BG in CM CSF specimens ranged from 18 to 3,300 pg/ml and in controls ranged from <3. Read More

    Integrative Medicine Preferences Among Coccidioidomycosis (Valley Fever) Patients.
    J Altern Complement Med 2017 Feb 24;23(2):135-139. Epub 2016 Aug 24.
    4 Division of Women's Health Internal Medicine & Integrative Medicine Program, Mayo Clinic Arizona , Scottsdale, AZ.
    Objectives: To understand the extent and modalities of integrative medicine strategies that patients with coccidioidomycosis (valley fever) have incorporated into their treatment regimens.

    Design: A direct patient survey was distributed, with 100 unique responses, at a single infectious diseases clinic at an academic medical center in Arizona. Eligible patients, defined as those with confirmed coccidioidomycosis or currently under evaluation, were polled on their personal use of 36 integrative medicine modalities. Read More

    Total and Lectin-Binding Proteome of Spherulin from Coccidioides posadasii.
    J Proteome Res 2016 Oct 29;15(10):3463-3472. Epub 2016 Aug 29.
    School of Life Sciences, Mayo Clinic Collaborative Research Building, Arizona State University , Scottsdale, Arizona 85259, United States.
    Coccidioides is a virulent dimorphic fungus that causes coccidioidomycosis (valley fever) in mammals, including humans. Although the genome has been sequenced, a proteomic analysis does not exist. To address this gap in proteomic knowledge, we generated the proteome of spherulin (a well-studied lysate of fungal spherules) and identified 1390 proteins. Read More

    Case of coccidioidomycosis in Ireland.
    BMJ Case Rep 2016 Aug 11;2016. Epub 2016 Aug 11.
    St Vincent's University Hospital, Dublin, Ireland.
    Coccidioidal infection is a well-recognised cause of pulmonary disease in certain parts of the south-western USA, Central and South America; however, it is rarely encountered elsewhere in the world. We describe the case of a previously healthy man presenting to a Dublin hospital with fever, dry cough and chest pain, following a visit to the western USA. Despite treatment with broad-spectrum antimicrobials, the patient developed progressive bilateral pulmonary infiltrates and a large pleural effusion. Read More

    Cutaneous involvement in the deep mycoses: A review. Part II -Systemic mycoses.
    Actas Dermosifiliogr 2016 Dec 4;107(10):816-822. Epub 2016 Aug 4.
    Departamento de Dermatología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
    In the second part of this review on the deep mycoses, we describe the main systemic mycoses-paracoccidioidomycosis, coccidioidomycosis, histoplasmosis, mucormycosis, and cryptococcosis-and their cutaneous manifestations. Skin lesions are only occasionally seen in deep systemic mycoses either directly, when the skin is the route of entry for the fungus, or indirectly, when the infection has spread from a deeper focus. These cutaneous signs are often the only clue to the presence of a potentially fatal infection. Read More

    Coccidioidomycosis in Patients with Selected Solid Organ Cancers: A Case Series and Review of Medical Literature.
    Mycopathologia 2016 Dec 4;181(11-12):787-798. Epub 2016 Aug 4.
    Division of Infectious Diseases, Mayo Clinic Hospital, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA.
    Coccidioidomycosis is a common infection in the desert southwestern USA; approximately 3 % of healthy persons in Arizona alone become infected annually. Coccidioidomycosis may be severe in immunocompromised persons, but experience among patients with solid organ cancer has not been fully described. Therefore, we aimed to describe the clinical courses of patients whose cancers were complicated by coccidioidomycosis at our institution, which is located in an area with endemic Coccidioides. Read More

    A Coccidioides posadasii CPS1 Deletion Mutant Is Avirulent and Protects Mice from Lethal Infection.
    Infect Immun 2016 Oct 19;84(10):3007-16. Epub 2016 Sep 19.
    School of Plant Sciences, The University of Arizona, Tucson, Arizona, USA The Valley Fever Center for Excellence, The University of Arizona, Tucson, Arizona, USA
    The CPS1 gene was identified as a virulence factor in the maize pathogen Cochliobolus heterostrophus Hypothesizing that the homologous gene in Coccidioides posadasii could be important for virulence, we created a Δcps1 deletion mutant which was unable to cause disease in three strains of mice (C57BL/6, BALB/c, or the severely immunodeficient NOD-scid,γc(null) [NSG]). Only a single colony was recovered from 1 of 60 C57BL/6 mice following intranasal infections of up to 4,400 spores. Following administration of very high doses (10,000 to 2. Read More

    2016 Infectious Diseases Society of America (IDSA) Clinical Practice Guideline for the Treatment of Coccidioidomycosis.
    Clin Infect Dis 2016 Sep 27;63(6):e112-46. Epub 2016 Jul 27.
    Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona.
    It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. Infectious Diseases Society of America considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances. Read More

    Coccidioidomycosis-Associated Deaths in California, 2000-2013.
    Public Health Rep 2016 Jul-Aug;131(4):531-5
    California Department of Public Health, Infectious Diseases Branch, Richmond, CA.
    The number of cases of coccidioidomycosis and associated hospitalizations increased in California during 2000-2013. During that period, a total of 1,098 death records listed coccidioidomycosis as a cause, averaging 78 deaths annually (range: 43-108). The death rate peaked in 2006 and was significantly higher among males than among females, among African American patients than among white patients, and among residents of the coccidioidomycosis-endemic region of California than among residents of the less endemic regions (p<0. Read More

    Infectious Complications With the Use of Biologic Response Modifiers in Infants and Children.
    Pediatrics 2016 Aug 18;138(2). Epub 2016 Jul 18.
    Biologic response modifiers (BRMs) are substances that interact with and modify the host immune system. BRMs that dampen the immune system are used to treat conditions such as juvenile idiopathic arthritis, psoriatic arthritis, or inflammatory bowel disease and often in combination with other immunosuppressive agents, such as methotrexate and corticosteroids. Cytokines that are targeted include tumor necrosis factor α; interleukins (ILs) 6, 12, and 23; and the receptors for IL-1α (IL-1A) and IL-1β (IL-1B) as well as other molecules. Read More

    Cross-reactivity between voriconazole, fluconazole and itraconazole.
    J Clin Pharm Ther 2016 Oct 19;41(5):566-7. Epub 2016 Jul 19.
    Department of Medicine, Kern Medical, Bakersfield, CA, USA.
    What Is Known And Objective: Hypersensitivity to triazoles is a rare occurrence and cross-reactivity between agents is unknown. We present a successful voriconazole challenge in a patient allergic to fluconazole and itraconazole.

    Case Summary: A 41-year-old immunocompetent male with coccidioidomycosis developed fever, eosinophilia and maculopapular rash from fluconazole. Read More

    Donor-Derived Coccidioides immitis Endocarditis and Disseminated Infection in the Setting of Solid Organ Transplantation.
    Open Forum Infect Dis 2016 Sep 5;3(3):ofw086. Epub 2016 May 5.
    Department of Cardiovascular Medicine , Stanford University School of Medicine , California.
    Background.  Endocarditis is a rare manifestation of infection with Coccidioides. This is the first reported case of donor-derived Coccidioides endocarditis obtained from a heart transplant. Read More

    Retrospective analysis of cutaneous lesions in 23 canine and 17 feline cases of coccidiodomycosis seen in Arizona, USA (2009-2015).
    Vet Dermatol 2016 Oct 10;27(5):346-e87. Epub 2016 Jul 10.
    Dermatology for Animals, 86 West Juniper Avenue, Gilbert, AZ 85233, USA.
    Background: Coccidioidomycosis is a fungal disease caused by the dimorphic saprophytic fungus Coccidioides immitis or C. posadasii. Primary pulmonary infection can disseminate to cutaneous and subcutaneous tissues, or less commonly direct cutaneous inoculation may occur. Read More

    Coccidioidomycosis Transmission Through Organ Transplantation: A Report of the OPTN Ad Hoc Disease Transmission Advisory Committee.
    Am J Transplant 2016 Jul 4. Epub 2016 Jul 4.
    Division of Pediatric Infectious Diseases, Department of Pediatrics and Surgery, University of Pittsburgh Medical School, Pittsburgh, PA.
    Donor-derived coccidioidomycosis has caused unexpected morbidity and mortality in transplant recipients. All proven or probable reports of donor-derived coccidioidomycosis to the Disease Transmission Advisory Committee between 2005 and August 2012 were reviewed. Six reports of proven or probable coccidioidomycosis were discovered. Read More

    Synthesis and in vitro antifungal activity of isoniazid-derived hydrazones against Coccidioides posadasii.
    Microb Pathog 2016 Sep 19;98:1-5. Epub 2016 Jun 19.
    Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Ceará, Brazil.
    Coccidioidomycosis is a potentially severe infection caused by dimorphic fungi Coccidioides immitis and Coccidioides posadasii. Although guidelines are well established, refractory disease is a matter of concern in the clinical management of coccidioidomycosis. In the present study three isoniazid-derived hydrazones N'-[(E)-1-(4-methoxyphenyl)ethylidene]pyridine-4-carbohydrazide, N'-[(E)-1-(4-methylphenyl)ethylidene]pyridine-4-carbohydrazide, and N'-[(E)-1-(phenyl)ethylidene]pyridine-4-carbohydrazide were synthesized and evaluated for antifungal activity against C. Read More

    Primary Cutaneous Coccidioidomycosis Presenting as a Recurrent Preauricular Cyst.
    Skinmed 2016 1;14(2):142-4. Epub 2016 Apr 1.
    Department of Dermatology and Pathology, Naval Medical Center San Diego, San Diego, CA (retired);
    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. Read More

    Coccidioides immitis Cervical Lymphadenitis Complicated by Esophageal Fistula.
    Case Rep Infect Dis 2016 23;2016:8715405. Epub 2016 May 23.
    Department of Internal Medicine, Oregon Health and Science University, Portland, OR 97239, USA; Division of Infectious Diseases, Oregon Health and Science University, Portland, OR 97239, USA.
    Coccidioidomycosis (valley fever) is caused by the dimorphic fungi Coccidioides immitis or Coccidioides posadasii. Most infections are asymptomatic or result in self-limited pneumonia; extrapulmonary dissemination via either hematogenous or lymphatic spread is rare. Here, we present a case of cervical C. Read More

    Climate Change and Respiratory Infections.
    Ann Am Thorac Soc 2016 Aug;13(8):1223-30
    3 Division of Pulmonary and Critical Care, University of Illinois at Chicago, Chicago, Illinois.
    The rate of global warming has accelerated over the past 50 years. Increasing surface temperature is melting glaciers and raising the sea level. More flooding, droughts, hurricanes, and heat waves are being reported. Read More

    Calcinospherules: A Unique Morphology of Dystrophic Calcification That Mimics Deep Fungal Infection.
    Am J Dermatopathol 2016 Jun;38(6):453-5
    *Jeremy Davis, MD, MS, Georgetown University School of Medicine, Washington, DC; and †David Geffen School of Medicine, University of California at Los Angeles.
    Dystrophic calcification may occur in association with cutaneous neoplasms. We report the case of a 50-year-old woman with unusual appearing dystrophic calcification that was mistaken for coccidiomycosis during Mohs micrographic surgery for an invasive squamous cell carcinoma on the lower lip. The term "calcinospherule" is suggested as a term to describe the round calcified bodies found within the lesion that mimicked spherules with endospores characteristic of Coccidioides imitis infection. Read More

    Use of Population Genetics to Assess the Ecology, Evolution, and Population Structure of Coccidioides.
    Emerg Infect Dis 2016 Jun;22(6):1022-30
    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. Read More

    Isavuconazole Treatment of Cryptococcosis and Dimorphic Mycoses.
    Clin Infect Dis 2016 Aug 11;63(3):356-62. Epub 2016 May 11.
    Department of Medicine/Division of Infectious Diseases, Duke University, Durham, North Carolina.
    Background: Invasive fungal diseases (IFD) caused by Cryptococcus and dimorphic fungi are associated with significant morbidity and mortality. Isavuconazole (ISAV) is a novel, broad-spectrum, triazole antifungal agent (IV and by mouth [PO]) developed for the treatment of IFD. It displays potent activity in vitro against these pathogens and in this report we examine outcomes of patients with cryptococcosis or dimorphic fungal infections treated with ISAV. Read More

    Local Population Structure and Patterns of Western Hemisphere Dispersal for Coccidioides spp., the Fungal Cause of Valley Fever.
    MBio 2016 Apr 26;7(2):e00550-16. Epub 2016 Apr 26.
    Mycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
    Unlabelled: Coccidioidomycosis (or valley fever) is a fungal disease with high morbidity and mortality that affects tens of thousands of people each year. This infection is caused by two sibling species, Coccidioides immitis and C. posadasii, which are endemic to specific arid locales throughout the Western Hemisphere, particularly the desert southwest of the United States. Read More

    PET/CT: First-Line Examination to Assess Disease Extent of Disseminated Coccidioidomycosis.
    J Nucl Med Technol 2016 Sep 21;44(3):212-3. Epub 2016 Apr 21.
    Department of Radiology, San Antonio Military Medical Center, Fort Sam Houston, Texas.
    Coccidioidomycosis is an infection caused by inhalation of the Coccidioides fungus. Most infections remain subclinical or are confined to the pulmonary system. Disseminated disease is rare. Read More

    Management of temporomandibular joint Coccidioidomycosis.
    Cranio 2016 Nov 13;34(6):402-405. Epub 2016 Apr 13.
    a Division of Plastic Surgery , Mayo Clinic , Rochester , MN , USA.
    Purpose: The aim of this report was to present the first known case of coccidioidomycosis involving the temporomandibular joint, review the literature regarding dissemination to the mandible, and to provide treatment recommendations for this challenging condition.

    Methods: Coccidioidomycosis of the mandibular condyle was identified in a 30-year-old Somali male residing in Arizona. Due to the difficulty of surgical access and the anticipated temporomandibular joint morbidity of radical condylar debridement, primary medical management was performed. Read More

    Flow Cytometric Analysis of Protective T-Cell Response Against Pulmonary Coccidioides Infection.
    Methods Mol Biol 2016 ;1403:551-66
    Department of Biology and South Texas Center for Emerging Infectious Diseases, University of Texas at San Antonio, San Antonio, TX, 78249, USA.
    The incidence of systemic fungal infections has increased throughout the world, spurring much interest in developing effective vaccines. Coccidioidomycosis, also known as San Joaquin Valley fever, is a potentially life-threatening respiratory mycosis. A vaccine against Coccidioides infection would contribute significantly to the well-being of the approx. Read More

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