Coccidioidomycosis as a common cause of community-acquired pneumonia.
The early manifestations of coccidioidomycosis (valley fever) are similar to those of other causes of community-acquired pneumonia (CAP). Without specific etiologic testing, the true frequency of valley fever may be underestimated by public health statistics. Therefore, we conducted a prospective observational study of adults with recent onset of a lower respiratory tract syndrome. Valley fever was serologically confirmed in 16 (29%) of 55 persons (95% confidence interval 16%-44%). Antimicrobial medications were used in 81% of persons with valley fever. Symptomatic differences at the time of enrollment had insufficient predictive value for valley fever to guide clinicians without specific laboratory tests. Thus, valley fever is a common cause of CAP after exposure in a disease-endemic region. If CAP develops in persons who travel or reside in Coccidioides-endemic regions, diagnostic evaluation should routinely include laboratory evaluation for this organism.
Valdivia
Lisa
L
University of Arizona College of Medicine, Tucson, Arizona 85723, USA.
Nix
David
D
Wright
Mark
M
Lindberg
Elizabeth
E
Fagan
Timothy
T
Lieberman
Donald
D
Stoffer
T'Prien
T
Ampel
Neil M
NM
Galgiani
John N
JN
D000328:Adult; D000908:Antibodies, Fungal / Q000097:blood; D001130:Arizona / Q000453:epidemiology; D003045:Coccidioides / Q000302:isolation & purification*; D003047:Coccidioidomycosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D005779:Immunodiffusion; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D011446:Prospective Studies
D000908:Antibodies, Fungal