Risk factors for severe pulmonary and disseminated coccidioidomycosis: Kern County, California, 1995-1996

Citation
Ne. Rosenstein et al., Risk factors for severe pulmonary and disseminated coccidioidomycosis: Kern County, California, 1995-1996, CLIN INF D, 32(5), 2001, pp. 708-714
Citations number
32
Categorie Soggetti
Clinical Immunolgy & Infectious Disease",Immunology
Journal title
CLINICAL INFECTIOUS DISEASES
ISSN journal
10584838 → ACNP
Volume
32
Issue
5
Year of publication
2001
Pages
708 - 714
Database
ISI
SICI code
1058-4838(20010301)32:5<708:RFFSPA>2.0.ZU;2-K
Abstract
Surveillance for coccidioidomycosis (CM) and a case-control study for risk factors among adults were conducted in Kern County, California. From Januar y 1995 through December 1996, 905 cases of CM were identified, for an annua l incidence of 86 cases per 100,000 population. A total of 380 adults were enrolled in the case-control study: 77 had severe pulmonary disease, 33 had disseminated disease, and 270 control patients had mild disease. Independe nt risk factors for severe pulmonary disease included diabetes, recent hist ory of cigarette smoking, income of <$ 15,000 per year, and older age. Oral antifungal therapy before hospitalization was associated with a reduced ri sk of CM pneumonia. Risk factors for disseminated disease were black race, income of <$ 15,000 per year, and pregnancy. Early treatment of CM with ora l antifungal agents may prevent severe pulmonary disease in groups consider ed to be at high risk, such as elderly individuals, persons with diabetes, and smokers. Persons at risk for severe CM may benefit from vaccination onc e an effective CM vaccine is available.