How is coccidioidomycosis treated during pregnancy?

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

Pregnancy can pose a clinical challenge. Pregnancy is a risk factor for disseminated coccidioidomycosis because of shifts in T-cell immunity, cytokine production, and hormone changes. Rates of dissemination and mortality are increased late in pregnancy, particularly in the third trimester.

Pregnant women who develop coccidioidomycosis and present with erythema nodosum are extremely unlikely to have a negative outcome, however. In addition, women who have a history of resolved infection prior to pregnancy do not have a significant rate of recrudescence.

Some of the older literature recommended that abortion be considered in pregnant women because of the virulent nature of coccidioidomycosis in these patients. More recent reviews of coccidioidomycosis in pregnancy, however, concluded that although the disease can complicate pregnancy, appropriate management has led to satisfactory outcomes for the mother and child, suggesting that abortion need not be recommended. [87, 88]


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