Treatment Of Pulmonary Coccidioidomycosis Research Articles

Treatment of pulmonary coccidioidomycosis after successful hepatitis C therapy in a patient with fluconazole induced hepatotoxicity

A patient with hepatitis C infection and cavitary pul- monary coccidioidomycosis is reported. Treatment of hepatitis C was associated with resolution of flucona- zole-induced hepatotoxicity. Successful treatment of he- patitis C enabled the patient to tolerate increaseing doses of fluconazole. This case highlights that hepatic toxicity of fluconazole can improve after successful treatment of hepatitis C.

Outcomes among Inmates Treated for Coccidioidomycosis at a Correctional Institution during a Community Outbreak, Kern County, California, 2004

Treatment of pulmonary coccidioidomycosis is typically limited to patients with severe disease or those with increased risk of dissemination. In response to an increase of coccidioidomycosis at a correctional institution in an endemic area, physicians initiated an enhanced diagnosis and treatment program. Case patients were inmates with laboratory-confirmed coccidioidomycosis during January 1, 2003, through October 31, 2004. We abstracted medical record data, including demographics, IgG complement fixation (CF) titers, treatment, and clinical outcome for initial and follow-up visits. Case patients receiving antifungal treatment were categorized into early (<or=4 weeks from symptom onset) and late treatment groups (>4 weeks after symptom onset). We evaluated clinical outcome, median IgG CF titer, and time to clinical improvement. Eighty-seven persons were diagnosed with coccidioidomycosis; 79 (91%) records were available. Median age was 36 years (range, 21-71 years), 34 (43%) were black, and all were male. Median time from symptom onset to diagnosis was 3 weeks (range, <1-36 weeks). Most (95%) received antifungal therapy; 32 were in the early treatment and 43 were in the late treatment group. Good clinical outcome was equally likely. In both groups, median peak IgG CF titers were 1:64. Titers in patients with early treatment did not decrease more rapidly. Median time to improvement was similar in early and late treatment groups (7 and 6 months, respectively; P = .6). Persons incarcerated in endemic areas constitute a susceptible population that should be considered at risk for coccidioidomycosis. Further studies are needed to identify populations that may benefit from early antifungal treatment for pulmonary coccidioidomycosis.

The surgical treatment of cavitary pulmonary coccidioidomycosis.

SURGICAL therapy is a well recognized method in the treatment of pulmonary coccidioidomycosis. This paper is confined solely to the surgery of the cavitary phase of this disease wherein postoperative complications are high. In view of this universally recognized hazard, an outline of a combined medical-surgical approach to reduce complications to a minimum will be presented. Mycology Fungi are simple plants, a plane higher than bacteria, of which only a few can cause disease in man, animals, or other plants. The fungus depends on living organisms for food and, therefore, is either saprophytic or parasitic in nature. Coccidioides immitis exists in two distinct phases—the saprophytic in external nature and on laboratory media and the parasitic in human or animal tissue. In the parasitic phase C immitis appears as a round, doubly refractile, walled spherule in infected tissue. Its cytoplasm divides by cleavage to form endospores which are liberated by rupture

SURGICAL TREATMENT OF PULMONARY COCCIDIOIDOMYCOSIS: A Ten-Year Study

SURGICAL TREATMENT OF PULMONARY COCCIDIOIDOMYCOSIS: A Ten-Year Study

The surgical treatment of pulmonary coccidioidomycosis with a comprehensive summary of the complications following this type of therapy.

The surgical treatment of pulmonary coccidioidomycosis with a comprehensive summary of the complications following this type of therapy.