What is coccidioidal fungemia in 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

This is a very rare, fulminant complication of disseminated coccidioidomycosis. Coccidioidal fungemia seems to be more common in patients with comorbidities and immunosuppressive states. The literature notes 113 cases, with about 38% associated with HIV; 18% with corticosteroids; 10% with solid organ transplants; and 4% with pregnancy. Dissemination occurred to the liver, spleen, and meninges/CNS, but endocarditis was not found. Serologic tests were positive in 87% patients. Overall mortality at 30 days was 62%, with a mean survival of 11.4 days. Survival is poorest in immunocompromised patients or those not receiving antifungal therapy. [46]


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