What are the racial predilections for coccidioidomycosis?

Updated: Aug 27, 2019
  • Author: Duane R Hospenthal, MD, PhD, FACP, FIDSA, FASTMH; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

No race predilection for primary infection with Coccidioides species has been observed. However, the risk of dissemination or progressive pulmonary disease is higher in Filipinos and blacks, and possibly in other Asians, Hispanics, and Native Americans. [30] The risk of dissemination is 175 times greater in Filipinos and 10 times greater in blacks than in non-Hispanic whites. [7] Hispanics with A or B type blood groups also have a slightly higher risk for advanced and/or disseminated disease compared with the population as a whole. [31]

This risk persists when analyses are controlled for age, sex, additional demographic features, concurrent medical problems, duration of exposure, and occupation. [32] When these populations are infected with the Coccidioides organism, their rate of skin test positivity decreases, and their complement-fixation titer increases compared with findings in the non-Hispanic white population.

One large study of 536 individuals demonstrated that 2.6% of non-Hispanic whites had dissemination, compared with 3.4% of Hispanic individuals, 7.3% of Filipinos, 22% of African Americans, and 20% of Asians. [33]


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