Coccidioidal pneumonia, Phoenix, Arizona, USA, 2000-2004.
Community-acquired pneumonia (CAP) often results in severe illness and death. In large, geographically defined areas where Coccidioides spp. are endemic, coccidioidomycosis is a recognized cause of CAP, but its frequency has not been studied extensively. To determine the frequency of patients with coccidioidomycosis, we conducted a prospective evaluation of 59 patients with CAP in the Phoenix, Arizona, area. Of 35 for whom paired coccidioidal serologic testing was performed, 6 (17%) had evidence of acute coccidioidomycosis. Coccidioidal pneumonia was more likely than noncoccidioidal CAP to produce rash. The following were not found to be risk factors or reliable predictors of infection: demographic features, underlying medical conditions, duration of time spent in disease-endemic areas, occupational and recreational activities, initial laboratory studies, and chest radiography findings. Coccidioidomycosis is a common cause of CAP in our patient population. In the absence of distinguishing clinical features, coccidioidal pneumonia can be identified only with appropriate laboratory studies.
Kim
Michelle M
MM
Mayo Clinic, Scottsdale, Arizona 85259, USA.
Blair
Janis E
JE
Carey
Elizabeth J
EJ
Wu
Qing
Q
Smilack
Jerry D
JD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001130:Arizona / Q000453:epidemiology; D003045:Coccidioides / Q000276:immunology / Q000302:isolation & purification / Q000472:pathogenicity; D003047:Coccidioidomycosis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D015994:Incidence; D008172:Lung Diseases, Fungal / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D012307:Risk Factors