What must be considered when treating coccidioidomycosis in high-risk patients?

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

Coccidioidal infection in immunocompromised individuals and specific groups of immunocompetent individuals follows a more aggressive course than in other groups. These include pregnant women, organ transplant recipients, and patients with HIV disease. Patients receiving immunosuppressive agents for cancer chemotherapy or autoimmune diseases or patients taking long-term corticosteroids are also at increased risk. [86] Progressive pulmonary disease occurs in 40% of immunocompromised individuals.

Although skin reactivity to coccidioidal antigens may be impaired, serologic response in all patients, except those with the most profound immunocompromise, remains intact.


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