Surgical management of coccidioidomycosis in children.
OBJECTIVE
Operations for Coccidioides immitis infection in children have received little study. The authors perceived an increase in the number of patients requiring operations for coccidioidomycosis at Phoenix Children's Hospital. The authors therefore reviewed the surgical management of children with C immitis infection in Phoenix, Arizona.


METHODS
The medical records of all children hospitalized from 1994 to 1999 with a confirmed laboratory diagnosis of coccidioidomycosis were reviewed. Age, gender, race, immune status, laboratory data, operations, and outcome were recorded.


RESULTS
Of 39 children with proven coccidioidomycosis, 21 patients (54%) underwent a total of 49 operations. Boys represented 72% of all children reviewed. Sixteen patients (29% of the operative cohort) were immunocompromised. Thoracic procedures (19 cases) were most frequent.


CONCLUSIONS
Over half the children hospitalized for coccidioidomycosis required at least 1 operation. Most were immunocompetent boys with thoracic disease. Pediatric surgeons, who provide the bulk of operative care, should expect to encounter coccidioidomycosis in endemic areas, and increasingly in nonendemic areas.
Connelly
M B
MB
Department of Pediatric Surgery, Phoenix Children's Hospital, AZ, USA.
Zerella
J T
JT
D000293:Adolescent; D017677:Age Distribution; D001130:Arizona / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003047:Coccidioidomycosis / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D012042:Registries; D012307:Risk Factors; D017678:Sex Distribution; D013514:Surgical Procedures, Operative / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome