UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2016 UpToDate®

Management of pulmonary sequelae and complications of coccidioidomycosis

Authors
John N Galgiani, MD
Shari L Meyerson, MD
Section Editor
Carol A Kauffman, MD
Deputy Editor
Jennifer Mitty, MD, MPH

INTRODUCTION

Approximately two-thirds of persons experience few or no symptoms following respiratory exposure to arthroconidia of Coccidioides spp. Those who become ill typically develop symptoms, such as cough, pleurisy, fever, and weight loss, one to three weeks after exposure; these symptoms generally resolve over the ensuing several months [1,2]. Marked fatigue, one of the common manifestations of the primary infection, may be especially prolonged and slow to resolve. Whether or not the primary exposure is recognized, most infections are self-limited without additional events or complications.

Occasional patients have persistent pulmonary consequences of coccidioidomycosis that require medical and/or surgical management, and these will be reviewed here. There are three major persistent pulmonary manifestations:

Residual pulmonary nodules

Coccidioidal cavities

Diffuse reticulonodular pneumonia

             

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Nov 2016. | This topic last updated: Fri Jan 24 00:00:00 GMT 2014.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2016 UpToDate, Inc.
References
Top
  1. Kerrick SS, Lundergan LL, Galgiani JN. Coccidioidomycosis at a university health service. Am Rev Respir Dis 1985; 131:100.
  2. Galgiani JN, Ampel NM, Blair JE, et al. Coccidioidomycosis. Clin Infect Dis 2005; 41:1217.
  3. Read CT. Coin lesion, pulmonary: in the Southwest. (Solitary pulmonary nodules). Ariz Med 1972; 29:775.
  4. Chitkara YK. Evaluation of cultures of percutaneous core needle biopsy specimens in the diagnosis of pulmonary nodules. Am J Clin Pathol 1997; 107:224.
  5. SMITH CE, BEARD RR, SAITO MT. Pathogenesis of coccidioidomycosis with special reference to pulmonary cavitation. Ann Intern Med 1948; 29:623.
  6. Cunningham RT, Einstein H. Coccidioidal pulmonary cavities with rupture. J Thorac Cardiovasc Surg 1982; 84:172.
  7. Santelli AC, Blair JE, Roust LR. Coccidioidomycosis in patients with diabetes mellitus. Am J Med 2006; 119:964.
  8. Galgiani JN, Catanzaro A, Cloud GA, et al. Comparison of oral fluconazole and itraconazole for progressive, nonmeningeal coccidioidomycosis. A randomized, double-blind trial. Mycoses Study Group. Ann Intern Med 2000; 133:676.
  9. Catanzaro A, Cloud GA, Stevens DA, et al. Safety, tolerance, and efficacy of posaconazole therapy in patients with nonmeningeal disseminated or chronic pulmonary coccidioidomycosis. Clin Infect Dis 2007; 45:562.
  10. Stevens DA, Rendon A, Gaona-Flores V, et al. Posaconazole therapy for chronic refractory coccidioidomycosis. Chest 2007; 132:952.
  11. Kim MM, Vikram HR, Kusne S, et al. Treatment of refractory coccidioidomycosis with voriconazole or posaconazole. Clin Infect Dis 2011; 53:1060.
  12. Ampel NM, Ryan KJ, Carry PJ, et al. Fungemia due to Coccidioides immitis. An analysis of 16 episodes in 15 patients and a review of the literature. Medicine (Baltimore) 1986; 65:312.
  13. Werner SB, Pappagianis D, Heindl I, Mickel A. An epidemic of coccidioidomycosis among archeology students in northern California. N Engl J Med 1972; 286:507.
  14. DiTomasso JP, Ampel NM, Sobonya RE, Bloom JW. Bronchoscopic diagnosis of pulmonary coccidioidomycosis. Comparison of cytology, culture, and transbronchial biopsy. Diagn Microbiol Infect Dis 1994; 18:83.
  15. Fish DG, Ampel NM, Galgiani JN, et al. Coccidioidomycosis during human immunodeficiency virus infection. A review of 77 patients. Medicine (Baltimore) 1990; 69:384.
  16. Sampaio EP, Hsu AP, Pechacek J, et al. Signal transducer and activator of transcription 1 (STAT1) gain-of-function mutations and disseminated coccidioidomycosis and histoplasmosis. J Allergy Clin Immunol 2013; 131:1624.