Coccidioidomycosis in patients with hematologic malignancies.
BACKGROUND
An endemic fungal infection of the desert southwestern United States, coccidioidomycosis is generally a self-limited illness in healthy persons. Immunosuppressed persons who contract coccidioidomycosis, however, are at increased risk for disseminated infection.


METHODS
We conducted a retrospective review of patients with coccidioidomycosis and hematologic malignancy or bone marrow disease.


RESULTS
Fifty-five patients were identified. The most common underlying malignancies were non-Hodgkin lymphoma and chronic lymphocytic leukemia. Extrathoracic (or disseminated) infection was observed in 12 patients (22%). Fifteen patients (27%) died with active coccidioidomycosis. Treatment of the hematologic disease with corticosteroids or antineoplastic chemotherapy increased the risk of death.


CONCLUSIONS
To date, this is the largest case series of patients with hematologic malignancy and coccidioidomycosis. In persons with hematologic malignancy, coccidioidomycosis can be a severe illness with a high risk for disseminated infection and death.
Blair
Janis E
JE
Division of Infectious Diseases, Mayo Clinic, Scottsdale, AZ 85259, USA. blair.janis@mayo.edu
Smilack
Jerry D
JD
Caples
Sean M
SM
D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001855:Bone Marrow Diseases / Q000188:drug therapy; D003047:Coccidioidomycosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D019337:Hematologic Neoplasms / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009894:Opportunistic Infections / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D015206:Southwestern United States; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents