Investigation of Incidence Rate, Demographics, and Clinical Manifestations of Coccidioidomycosis in a West Texas Regional Referral Medical Center, From January 2004 to December 2012

Abstract

Objectives: Coccidioidomycosis is an endemic disease causing significant mortality and morbidityin Southwestern United States. Our group recognized recurring and increasing cases of Coccidioidomycosis in a west Texas regional referral medical center between 2004 and 2012; therefore, we endeavored to identify key characteristics of this endemic West Texas disease. Methods: This retrospective chart review contains all pertinent hospitalizations identified by searching the medical center laboratory records for the keywords of “Fungus” or “coccidioides” on immunoglobulin assays and fungal cultures. The positive laboratory results from January 2004 through December 2012 derive the basis for identification of the patient medical records reviewed. Data extracted from medical records, using a standardized form, includes the multivariates of age, gender, ethnicity, comorbid illness, and body system infected (respiratory, musculoskeletal, gastrointestinal, neurological etc). Subsequently data correlation analyses show the incidence trend and student t test assesses the mean of patient ages. Chi-square test reveals results for other data elements. Results: During a five-year period, laboratory confirmed cases of Coccidioidomycosis have steadily risen to a 70.3% increase in 2012 compared to 2008. On average, the age of male and female patients is 52.08 (± 15.81) and 55.86 (± 14.51) years old, respectively. Identifiable risk factors include male gender, African-American race and the comorbidity of malignancy. Conclusion: The increasing incidence of Coccidioidomycosis cases at a regional referral medical center of west Texas indicates a pressing need for further epidemiological study throughout this large geographic endemic region and perhaps classification of Coccidioidomycosis as “reportable” in the state of Texas.