Coccidioidomycosis: Clinical Update

Neil M. Ampel, Manon A. Wieden, John N. Galgian

Research output: Contribution to journalArticle

58 Scopus citations

Abstract

Over the last decade coccidioidomycosis, a fungal infection endemic to the desert Southwest of the United States, has gained national prominence. This review summarizes recent advances in the clinical understanding of this disease. Immunosuppressive therapy and infection with the human immunodeficiency virus are recognized risk factors for the development of severe, progressive disease. Although relatively uncommon, extrapulmonary dissemination of Coccidioides immitis can lead to chronic infection ofthe skin, bones, and meninges. Culture and histologic examination are important in establishment of the diagnosis, but serologic tests remain both diagnostically and prognostically useful. lteatment is problematic. Coccidioidomycosis is an unpredictable disease, and assessments of drug efficacy are difficult. Ketoconazole is challenging amphotericin B as the preferred treatment for some manifestations. However, many of the adverse effects of ketoconazole have only recently been recognized. Newer antifungal agents, such as fluconazole and itraconazole, hold promise for the future.

Original languageEnglish (US)
Pages (from-to)897-911
Number of pages15
JournalReviews of infectious diseases
Volume11
Issue number6
DOIs
StatePublished - Nov 1989

ASJC Scopus subject areas

  • Microbiology (medical)

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