Coccidioidomycosis: Changes in clinical expression, serological diagnosis, and therapeutic options

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Abstract

Coccidioidomycosis occurs in +~ 50,000 persons each year. As concurrent infections with the human immunodeficiency virus become more frequent, the spectrum of coccidioidal illness has shifted toward more extensive and life-threatening disease. This trend has intensified interest in developing more-sensitive methods for diagnosis of coccidioidal infection early in its course. ELISA procedures that detect fungal antigen and antibodies in patient sera have been devised but require more-purified antigens for clinically useful specificity. Clinical trials of new drugs have been initiated that may offer advantages in safety, efficacy, or ease of administration. Itraconazole and fluconazole show promise, especially in the treatment of coccidioidal meningitis. However, it has not yet been determined whether either antifungal agent is more effective than established agents, such as amphotericin B or ketoconazole. These changes in the clinical spectrum, methods of diagnosis, and therapeutic options will likely influence the medical approach to coccidioidal infections in coming years.

Original languageEnglish (US)
JournalClinical Infectious Diseases
Volume14
Issue number1 SUPPL.
StatePublished - 1992

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Coccidioidomycosis
Fungal Antibodies
Fungal Antigens
Infection
Ketoconazole
Itraconazole
Fluconazole
Antifungal Agents
Amphotericin B
Meningitis
Therapeutics
Enzyme-Linked Immunosorbent Assay
Clinical Trials
HIV
Safety
Antigens
Serum
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Immunology

Cite this

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abstract = "Coccidioidomycosis occurs in +~ 50,000 persons each year. As concurrent infections with the human immunodeficiency virus become more frequent, the spectrum of coccidioidal illness has shifted toward more extensive and life-threatening disease. This trend has intensified interest in developing more-sensitive methods for diagnosis of coccidioidal infection early in its course. ELISA procedures that detect fungal antigen and antibodies in patient sera have been devised but require more-purified antigens for clinically useful specificity. Clinical trials of new drugs have been initiated that may offer advantages in safety, efficacy, or ease of administration. Itraconazole and fluconazole show promise, especially in the treatment of coccidioidal meningitis. However, it has not yet been determined whether either antifungal agent is more effective than established agents, such as amphotericin B or ketoconazole. These changes in the clinical spectrum, methods of diagnosis, and therapeutic options will likely influence the medical approach to coccidioidal infections in coming years.",
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