Surgery for coccidioidomycosis in 52 diabetic patients with special reference to related immunologic factors.
Fifty-two diabetic patients who underwent pulmonary surgery for coccidioiodmycosis were evaluated by a retrospective study which included classification by stage of disease, status of insulin dependency, and reaction to coccidioidin skin test. The insulin-dependent diabetic patient had a fourfold increase in the incidence of more severe (progressive) disease. Perioperative therapy with amphotericin B may be of value in the adult surgical candidate with progressive disease but is not necessary or desirable in the juvenile diabetic patient. Coccidioidomycosis is a disease of relative immunocompromise, and a negative skin test should herald such compromise and support a decision for surgery. Such surgery in the progressive stages should be totally extirpative. The presence of inadequately resected disease may adversely affect subsequent immunologic resistance of the host.
D000328:Adult; D000367:Age Factors; D000666:Amphotericin B / Q000627:therapeutic use; D003047:Coccidioidomycosis / Q000188:drug therapy / Q000276:immunology / Q000601:surgery*; D048909:Diabetes Complications; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D005260:Female; D006801:Humans; D008172:Lung Diseases, Fungal / Q000188:drug therapy / Q000276:immunology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D012882:Skin Tests
D000666:Amphotericin B