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Semin Respir Crit Care Med 2015; 36(05): 746-755
DOI: 10.1055/s-0035-1562900
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Coccidioidomycosis: Recent Updates

Meryl Twarog
1   Division of Infectious Diseases, Department of Internal Medicine, University of California Davis Medical Center, Davis, California
,
George R. Thompson III
1   Division of Infectious Diseases, Department of Internal Medicine, University of California Davis Medical Center, Davis, California
2   Department of Medical Microbiology and Immunology, University of California, Davis, California
› Author Affiliations
Further Information

Publication History

Publication Date:
23 September 2015 (online)

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Abstract

Coccidioidomycosis manifests as a variety of clinical manifestations and ranges in severity from asymptomatic exposure with resultant immunity to reinfection, to fulminant, and life-threatening disseminated disease. Primary coccidioidal pneumonia represents the most common clinical form of infection, and the incidence continues to increase. Within the endemic region, primary pulmonary coccidioidomycosis represents up to 29% of all community-acquired pneumonia emphasizing the frequency with which clinicians encounter this endemic mycosis. Chronic infection develops in 3 to 5% of patients, and almost all morbidity and mortality observed in coccidioidomycosis occur in these forms (e.g., chronic pulmonary disease, extrapulmonary manifestations). This review summarizes the ecology, epidemiology, manifestations of disease, and treatment options currently available for coccidioidomycosis.

Keywords

coccidioidomycosis - Coccidioides - Valley Fever - treatment - epidemiology - review
 

  • References

  • 1 Nguyen C, Barker BM, Hoover S , et al. Recent advances in our understanding of the environmental, epidemiological, immunological, and clinical dimensions of coccidioidomycosis. Clin Microbiol Rev 2013; 26 (3) 505-525
    CrossrefPubMedGoogle Scholar
  • 2 Hirschmann JV. The early history of coccidioidomycosis: 1892-1945. Clin Infect Dis 2007; 44 (9) 1202-1207
    CrossrefPubMedGoogle Scholar
  • 3 Rixford E, Gilchrist TC. Two cases of protozoan (coccidioidal) infection of the skin and other organs. Johns Hopkins Hosp Rep 1896; 10: 209-268
    PubMedGoogle Scholar
  • 4 Dickson EC, Gifford MA. Coccidioides infection (coccidioidomycosis). ii. The primary type of infection. Arch Intern Med 1938; 62: 853-871
    CrossrefPubMedGoogle Scholar
  • 5 Thompson III GR, How I. Treat Coccidioidomycosis. Current Management of Fungal Infections 2013; 7: 29-35
    PubMedGoogle Scholar
  • 6 Kolivras KN, Comrie AC. Modeling valley fever (coccidioidomycosis) incidence on the basis of climate conditions. Int J Biometeorol 2003; 47 (2) 87-101
    PubMedGoogle Scholar
  • 7 Fisher FS, Bultman MW, Johnson SM, Pappagianis D, Zaborsky E. Coccidioides niches and habitat parameters in the southwestern United States: a matter of scale. Ann N Y Acad Sci 2007; 1111: 47-72
    CrossrefPubMedGoogle Scholar
  • 8 Emmons CW, Ashburn LL. The isolation of Haplosporangium parvum n. sp. and Coccidioides immitis from wild rodents. Their relationship to coccidioidomycosis. Public Health Rep 1942; 57 (46) 1715-1727
    CrossrefPubMedGoogle Scholar
  • 9 Maddy KT, Crecelius HG. Establishment of Coccidioides immitis in negative soil following burial of infected animals and animal tissues. In: Ajello L, ed., Coccidioidomycosis. Tucson, AZ: University of Arizona Press; 1965: 309-312
    Google Scholar
  • 10 Greene DR, Koenig G, Fisher MC , et al. Soil isolation and molecular identification of Coccidioides immitis . Mycologia 2000; 92 (3) 406-410
    CrossrefPubMedGoogle Scholar
  • 11 Thompson III GR, Stevens DA, Clemons KV , et al. Call for a California coccidioidomycosis consortium to face the top ten challenges posed by a recalcitrant regional disease. Mycopathologia 2015; 179 (1-2) 1-9
    CrossrefPubMedGoogle Scholar
  • 12 Barker BM, Jewell KA, Kroken S, Orbach MJ. The population biology of Coccidioides: epidemiologic implications for disease outbreaks. Ann N Y Acad Sci 2007; 1111: 147-163
    CrossrefPubMedGoogle Scholar
  • 13 Laniado-Laborin R. Expanding understanding of epidemiology of coccidioidomycosis in the Western hemisphere. Ann N Y Acad Sci 2007; 1111: 19-34
    CrossrefPubMedGoogle Scholar
  • 14 Saubolle MA, McKellar PP, Sussland D. Epidemiologic, clinical, and diagnostic aspects of coccidioidomycosis. J Clin Microbiol 2007; 45 (1) 26-30
    CrossrefPubMedGoogle Scholar
  • 15 Brown J, Benedict K, Park BJ, Thompson III GR. Coccidioidomycosis: epidemiology. Clin Epidemiol 2013; 5: 185-197
    PubMedGoogle Scholar
  • 16 Colombo AL, Tobón A, Restrepo A, Queiroz-Telles F, Nucci M. Epidemiology of endemic systemic fungal infections in Latin America. Med Mycol 2011; 49 (8) 785-798
    PubMedGoogle Scholar
  • 17 Baddley JW, Winthrop KL, Patkar NM , et al. Geographic distribution of endemic fungal infections among older persons, United States. Emerg Infect Dis 2011; 17 (9) 1664-1669
    CrossrefPubMedGoogle Scholar
  • 18 Marsden-Haug N, Hill H, Litvintseva AP , et al; Centers for Disease Control and Prevention (CDC). Coccidioides immitis identified in soil outside of its known range - Washington, 2013. MMWR Morb Mortal Wkly Rep 2014; 63 (20) 450
    PubMedGoogle Scholar
  • 19 Litvintseva AP, Marsden-Haug N, Hurst S , et al. Valley fever: finding new places for an old disease: Coccidioides immitis found in Washington State soil associated with recent human infection. Clin Infect Dis 2015; 60 (1) e1-e3
    CrossrefPubMedGoogle Scholar
  • 20 [Anonymous] Centers for Disease Control and Prevention (CDC). Increase in reported coccidioidomycosis—United States, 1998-2011. MMWR Morb Mortal Wkly Rep 2013; 62 (12) 217-221
    PubMedGoogle Scholar
  • 21 Sondermeyer G, Lee L, Gilliss D, Tabnak F, Vugia D. Coccidioidomycosis-associated hospitalizations, California, USA, 2000-2011. Emerg Infect Dis 2013; 19 (10) 1590-1597
    PubMedGoogle Scholar
  • 22 [Anonymous]. From the Centers for Disease Control and Prevention. Coccidioidomycosis in workers at an archeologic site—Dinosaur National Monument, Utah, June-July 2001. JAMA 2001; 286 (24) 3072-3073
    CrossrefPubMedGoogle Scholar
  • 23 Petersen LR, Marshall SL, Barton-Dickson C , et al. Coccidioidomycosis among workers at an archeological site, northeastern Utah. Emerg Infect Dis 2004; 10 (4) 637-642
    CrossrefPubMedGoogle Scholar
  • 24 Werner SB, Pappagianis D, Heindl I, Mickel A. An epidemic of coccidioidomycosis among archeology students in northern California. N Engl J Med 1972; 286 (10) 507-512
    CrossrefPubMedGoogle Scholar
  • 25 Bergstrom L, Yocum DE, Ampel NM , et al. Increased risk of coccidioidomycosis in patients treated with tumor necrosis factor alpha antagonists. Arthritis Rheum 2004; 50 (6) 1959-1966
    CrossrefPubMedGoogle Scholar
  • 26 Blair JE, Logan JL. Coccidioidomycosis in solid organ transplantation. Clin Infect Dis 2001; 33 (9) 1536-1544
    CrossrefPubMedGoogle Scholar
  • 27 Glenn TJ, Blair JE, Adams RH. Coccidioidomycosis in hematopoietic stem cell transplant recipients. Med Mycol 2005; 43 (8) 705-710
    CrossrefPubMedGoogle Scholar
  • 28 Masannat FY, Ampel NM. Coccidioidomycosis in patients with HIV-1 infection in the era of potent antiretroviral therapy. Clin Infect Dis 2010; 50 (1) 1-7
    CrossrefPubMedGoogle Scholar
  • 29 Rosenstein NE, Emery KW, Werner SB , et al. Risk factors for severe pulmonary and disseminated coccidioidomycosis: Kern County, California, 1995-1996. Clin Infect Dis 2001; 32 (5) 708-715
    CrossrefPubMedGoogle Scholar
  • 30 Thompson III GR, Bays D, Taylor SL, Cohen SH, Pappagianis D. Association between serum 25-hydroxyvitamin D level and type of coccidioidal infection. Med Mycol 2013; 51 (3) 319-323
    CrossrefPubMedGoogle Scholar
  • 31 Chen S, Erhart LM, Anderson S , et al. Coccidioidomycosis: knowledge, attitudes, and practices among healthcare providers—Arizona, 2007. Med Mycol 2011; 49 (6) 649-656
    PubMedGoogle Scholar
  • 32 Vugia DJ, Wheeler C, Cummings KC, Karon A. Coccidioidomycosis—California, 2000–2007. MMWR Morb Mortal Wkly Rep 2009; 58: 105-109
    PubMedGoogle Scholar
  • 33 Sunenshine RH, Anderson S, Erhart L , et al. Public health surveillance for coccidioidomycosis in Arizona. Ann N Y Acad Sci 2007; 1111: 96-102
    CrossrefPubMedGoogle Scholar
  • 34 Blair JE, Chang YH, Cheng MR , et al. Characteristics of patients with mild to moderate primary pulmonary coccidioidomycosis. Emerg Infect Dis 2014; 20 (6) 983-990
    PubMedGoogle Scholar
  • 35 Crum NF, Lederman ER, Stafford CM, Parrish JS, Wallace MR. Coccidioidomycosis: a descriptive survey of a reemerging disease. Clinical characteristics and current controversies. Medicine (Baltimore) 2004; 83 (3) 149-175
    CrossrefPubMedGoogle Scholar
  • 36 Lonky SA, Catanzaro A, Moser KM, Einstein H. Acute coccidioidal pleural effusion. Am Rev Respir Dis 1976; 114 (4) 681-688
    PubMedGoogle Scholar
  • 37 Merchant M, Romero AO, Libke RD, Joseph J. Pleural effusion in hospitalized patients with Coccidioidomycosis. Respir Med 2008; 102 (4) 537-540
    CrossrefPubMedGoogle Scholar
  • 38 Jude CM, Nayak NB, Patel MK, Deshmukh M, Batra P. Pulmonary coccidioidomycosis: pictorial review of chest radiographic and CT findings. Radiographics 2014; 34 (4) 912-925
    CrossrefPubMedGoogle Scholar
  • 39 Mayer AP, Morris MF, Panse PM , et al. Does the presence of mediastinal adenopathy confer a risk for disseminated infection in immunocompetent persons with pulmonary coccidioidomycosis?. Mycoses 2013; 56 (2) 145-149
    CrossrefPubMedGoogle Scholar
  • 40 Arsura EL, Kilgore WB. Miliary coccidioidomycosis in the immunocompetent. Chest 2000; 117 (2) 404-409
    CrossrefPubMedGoogle Scholar
  • 41 Thompson III GR. Pulmonary coccidioidomycosis. Semin Respir Crit Care Med 2011; 32 (6) 754-763
    Article in Thieme ConnectPubMedGoogle Scholar
  • 42 Reyes N, Onadeko OO, Luraschi-Monjagatta Mdel C , et al. Positron emission tomography in the evaluation of pulmonary nodules among patients living in a coccidioidal endemic region. Lung 2014; 192 (4) 589-593
    CrossrefPubMedGoogle Scholar
  • 43 Parish JM, Blair JE. Coccidioidomycosis. Mayo Clin Proc 2008; 83 (3) 343-348 , quiz 348–349
    CrossrefPubMedGoogle Scholar
  • 44 Sobonya RE, Yanes J, Klotz SA. Cavitary pulmonary coccidioidomycosis: pathologic and clinical correlates of disease. Hum Pathol 2014; 45 (1) 153-159
    CrossrefPubMedGoogle Scholar
  • 45 Szeyko LA, Taljanovic MS, Dzioba RB, Rapiejko JL, Adam RD. Vertebral coccidioidomycosis: presentation and multidisciplinary management. Am J Med 2012; 125 (3) 304-314
    CrossrefPubMedGoogle Scholar
  • 46 Thompson III G, Wang S, Bercovitch R , et al. Routine CSF analysis in coccidioidomycosis is not required. PLoS ONE 2013; 8 (5) e64249
    CrossrefPubMedGoogle Scholar
  • 47 Johnson RH, Einstein HE. Coccidioidal meningitis . Clin Infect Dis 2006; 42 (1) 103-107
    CrossrefPubMedGoogle Scholar
  • 48 Ampel NM, Giblin A, Mourani JP, Galgiani JN. Factors and outcomes associated with the decision to treat primary pulmonary coccidioidomycosis. Clin Infect Dis 2009; 48 (2) 172-178
    CrossrefPubMedGoogle Scholar
  • 49 Blair JE, Mayer AP, Currier J, Files JA, Wu Q. Coccidioidomycosis in elderly persons. Clin Infect Dis 2008; 47 (12) 1513-1518
    CrossrefPubMedGoogle Scholar
  • 50 Mischel PS, Vinters HV. Coccidioidomycosis of the central nervous system: neuropathological and vasculopathic manifestations and clinical correlates. Clin Infect Dis 1995; 20 (2) 400-405
    CrossrefPubMedGoogle Scholar
  • 51 Huppert M, Peterson ET, Sun SH, Chitjian PA, Derrevere WJ. Evaluation of a latex particle agglutination test for coccidioidomycosis. Am J Clin Pathol 1968; 49 (1) 96-102
    CrossrefPubMedGoogle Scholar
  • 52 Kuberski T, Herrig J, Pappagianis D. False-positive IgM serology in coccidioidomycosis. J Clin Microbiol 2010; 48 (6) 2047-2049
    CrossrefPubMedGoogle Scholar
  • 53 Pappagianis D, Krasnow RI, Beall S. False-positive reactions of cerebrospinal fluid and diluted sera with the coccidioidal latex-agglutination test. Am J Clin Pathol 1976; 66 (5) 916-921
    CrossrefPubMedGoogle Scholar
  • 54 Thompson III GR, Lunetta JM, Johnson SM , et al. Early treatment with fluconazole may abrogate the development of IgG antibodies in coccidioidomycosis. Clin Infect Dis 2011; 53 (6) e20-e24
    CrossrefPubMedGoogle Scholar
  • 55 Mendoza N, Blair JE. The utility of diagnostic testing for active coccidioidomycosis in solid organ transplant recipients. Am J Transplant 2013; 13 (4) 1034-1039
    CrossrefPubMedGoogle Scholar
  • 56 Thompson III GR, Bays DJ, Johnson SM, Cohen SH, Pappagianis D, Finkelman MA. Serum (1->3)-β-D-glucan measurement in coccidioidomycosis. J Clin Microbiol 2012; 50 (9) 3060-3062
    CrossrefPubMedGoogle Scholar
  • 57 Vucicevic D, Blair JE, Binnicker MJ , et al. The utility of Coccidioides polymerase chain reaction testing in the clinical setting. Mycopathologia 2010; 170 (5) 345-351
    CrossrefPubMedGoogle Scholar
  • 58 Thompson GR, Sharma S, Bays DJ , et al. Coccidioidomycosis: adenosine deaminase levels, serologic parameters, culture results, and polymerase chain reaction testing in pleural fluid. Chest 2013; 143 (3) 776-781
    CrossrefPubMedGoogle Scholar
  • 59 Gago S, Buitrago MJ, Clemons KV, Cuenca-Estrella M, Mirels LF, Stevens DA. Development and validation of a quantitative real-time PCR assay for the early diagnosis of coccidioidomycosis. Diagn Microbiol Infect Dis 2014; 79 (2) 214-221
    CrossrefPubMedGoogle Scholar
  • 60 Galgiani JN, Ampel NM, Blair JE , et al; Infectious Diseases Society of America. Coccidioidomycosis. Clin Infect Dis 2005; 41 (9) 1217-1223
    CrossrefPubMedGoogle Scholar
  • 61 Galgiani JN, Catanzaro A, Cloud GA , et al; Mycoses Study Group. Comparison of oral fluconazole and itraconazole for progressive, nonmeningeal coccidioidomycosis. A randomized, double-blind trial. Ann Intern Med 2000; 133 (9) 676-686
    CrossrefPubMedGoogle Scholar
  • 62 Graybill JR, Stevens DA, Galgiani JN, Dismukes WE, Cloud GA ; NAIAD Mycoses Study Group. Itraconazole treatment of coccidioidomycosis. Am J Med 1990; 89 (3) 282-290
    CrossrefPubMedGoogle Scholar
  • 63 Prabhu RM, Bonnell M, Currier BL, Orenstein R. Successful treatment of disseminated nonmeningeal coccidioidomycosis with voriconazole. Clin Infect Dis 2004; 39 (7) e74-e77
    CrossrefPubMedGoogle Scholar
  • 64 Kim MM, Vikram HR, Kusne S, Seville MT, Blair JE. Treatment of refractory coccidioidomycosis with voriconazole or posaconazole. Clin Infect Dis 2011; 53 (11) 1060-1066
    CrossrefPubMedGoogle Scholar
  • 65 Thompson III GR, Bays D, Cohen SH, Pappagianis D. Fluoride excess in coccidioidomycosis patients receiving long-term antifungal therapy: an assessment of currently available triazoles. Antimicrob Agents Chemother 2012; 56 (1) 563-564
    CrossrefPubMedGoogle Scholar
  • 66 Lat A, Thompson III GR. Update on the optimal use of voriconazole for invasive fungal infections. Infect Drug Resist 2011; 4: 43-53
    PubMedGoogle Scholar
  • 67 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 (5) 562-568
    CrossrefPubMedGoogle Scholar
  • 68 Bercovitch RS, Catanzaro A, Schwartz BS, Pappagianis D, Watts DH, Ampel NM. Coccidioidomycosis during pregnancy: a review and recommendations for management. Clin Infect Dis 2011; 53 (4) 363-368
    CrossrefPubMedGoogle Scholar
  • 69 Blair JE. Coccidioidal meningitis: update on epidemiology, clinical features, diagnosis, and management. Curr Infect Dis Rep 2009; 11 (4) 289-295
    CrossrefPubMedGoogle Scholar
  • 70 Dewsnup DH, Galgiani JN, Graybill JR , et al. Is it ever safe to stop azole therapy for Coccidioides immitis meningitis?. Ann Intern Med 1996; 124 (3) 305-310
    CrossrefPubMedGoogle Scholar
  • 71 Stevens DA, Shatsky SA. Intrathecal amphotericin in the management of coccidioidal meningitis. Semin Respir Infect 2001; 16 (4) 263-269
    CrossrefPubMedGoogle Scholar
  • 72 Kriesel JD, Sutton DA, Schulman S, Fothergill AW, Rinaldi MG. Persistent pulmonary infection with an azole-resistant Coccidioides species. Med Mycol 2008; 46 (6) 607-610
    CrossrefPubMedGoogle Scholar
  • 73 González GM, Tijerina R, Najvar LK , et al. Correlation between antifungal susceptibilities of Coccidioides immitis in vitro and antifungal treatment with caspofungin in a mouse model. Antimicrob Agents Chemother 2001; 45 (6) 1854-1859
    CrossrefPubMedGoogle Scholar
  • 74 Levy ER, McCarty JM, Shane AL, Weintrub PS. Treatment of pediatric refractory coccidioidomycosis with combination voriconazole and caspofungin: a retrospective case series. Clin Infect Dis 2013; 56 (11) 1573-1578
    CrossrefPubMedGoogle Scholar
  • 75 Ampel NM, Kramer LA. In vitro modulation of cytokine production by lymphocytes in human coccidioidomycosis. Cell Immunol 2003; 221 (2) 115-121
    CrossrefPubMedGoogle Scholar
  • 76 Ampel NM, Christian L. In vitro modulation of proliferation and cytokine production by human peripheral blood mononuclear cells from subjects with various forms of coccidioidomycosis. Infect Immun 1997; 65 (11) 4483-4487
    PubMedGoogle Scholar
  • 77 Vinh DC, Masannat F, Dzioba RB, Galgiani JN, Holland SM. Refractory disseminated coccidioidomycosis and mycobacteriosis in interferon-gamma receptor 1 deficiency. Clin Infect Dis 2009; 49 (6) e62-e65
    CrossrefPubMedGoogle Scholar
  • 78 Vinh DC. Coccidioidal meningitis: disseminated disease in patients without HIV/AIDS. Medicine (Baltimore) 2011; 90 (1) 87
    CrossrefPubMedGoogle Scholar
  • 79 Kuberski TT, Servi RJ, Rubin PJ. Successful treatment of a critically ill patient with disseminated coccidioidomycosis, using adjunctive interferon-gamma. Clin Infect Dis 2004; 38 (6) 910-912
    CrossrefPubMedGoogle Scholar
  • 80 Li RK, Rinaldi MG. In vitro antifungal activity of nikkomycin Z in combination with fluconazole or itraconazole. Antimicrob Agents Chemother 1999; 43 (6) 1401-1405
    PubMedGoogle Scholar
  • 81 Hector RF, Davidson AP, Johnson SM. Comparison of susceptibility of fungal isolates to lufenuron and nikkomycin Z alone or in combination with itraconazole. Am J Vet Res 2005; 66 (6) 1090-1093
    CrossrefPubMedGoogle Scholar
  • 82 Shubitz LF, Trinh HT, Perrill RH , et al. Modeling nikkomycin Z dosing and pharmacology in murine pulmonary coccidioidomycosis preparatory to phase 2 clinical trials. J Infect Dis 2014; 209 (12) 1949-1954
    CrossrefPubMedGoogle Scholar
  • 83 Pappagianis D. Seeking a vaccine against Coccidioides immitis and serologic studies: expectations and realities. Fungal Genet Biol 2001; 32 (1) 1-9
    CrossrefPubMedGoogle Scholar