title: Coccidioidomycosis in Patients with Selected Solid Organ Cancers: A Case Series and Review of Medical Literature.
abstract: Coccidioidomycosis is a common infection in the desert southwestern USA; approximately 3 % of healthy persons in Arizona alone become infected annually. Coccidioidomycosis may be severe in immunocompromised persons, but experience among patients with solid organ cancer has not been fully described. Therefore, we aimed to describe the clinical courses of patients whose cancers were complicated by coccidioidomycosis at our institution, which is located in an area with endemic Coccidioides. To do so, we conducted a retrospective review from January 1, 2000, through December 31, 2014, of all patients with breast, colorectal, or ovarian cancer whose cancer courses were complicated by coccidioidomycosis. We identified 17,576 cancer patients; 14 (0.08 %) of these patients met criteria for proven or probable coccidioidomycosis diagnosed within the first 2 years after the cancer diagnosis. All of these patients had primary pulmonary coccidioidomycosis, none had relapsed prior infection, and 1 had possible extrapulmonary dissemination. Five had active coccidioidal infection during chemotherapy, 1 of whom was hospitalized for coccidioidal pneumonia. All were treated with fluconazole, and all improved clinically. Eleven did not require prolonged courses of fluconazole. There were no clearly demonstrated episodes of relapsed infection. In conclusion, coccidioidomycosis was not a common complication of breast, colorectal, or ovarian cancers in patients treated at our institution, and it was not commonly complicated by severe or disseminated infection.
authors: Department of Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA.|Private Practice, Billings, MT, USA.
authors: Colin
authors: C
authors: Fitterer
authors: Department of Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA.
authors: Zachary
authors: Z
authors: Berg
authors: Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA.
authors: Thorvardur R
authors: TR
authors: Halfdanarson
authors: Division of Infectious Diseases, Mayo Clinic Hospital, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA.
authors: Holenarasipur R
authors: HR
authors: Vikram
authors: Division of Infectious Diseases, Mayo Clinic Hospital, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA.
authors: Shimon
authors: S
authors: Kusne
authors: Division of Infectious Diseases, Mayo Clinic Hospital, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA.
authors: Robert
authors: R
authors: Orenstein
authors: Division of Infectious Diseases, Mayo Clinic Hospital, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA.
authors: Maria Teresa
authors: MT
authors: Seville
authors: Division of Infectious Diseases, Mayo Clinic Hospital, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA. blair.janis@mayo.edu.
authors: Janis E
authors: JE
authors: Blair
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D001130:Arizona / Q000453:epidemiology; D003047:Coccidioidomycosis / Q000188:drug therapy / Q000453:epidemiology*; D019353:Endemic Diseases; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D015995:Prevalence; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole
keywords: Breast cancer; Coccidioides; Coccidioidomycosis; Colorectal cancer; Ovarian cancer; Tumor