Semin Respir Crit Care Med 2020; 41(01): 042-052
DOI: 10.1055/s-0039-3400998
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pulmonary Coccidioidomycosis

Kathryn E. Kimes*
1   Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, Arizona
,
Sabirah N. Kasule*
2   Department of Internal Medicine, Mayo Clinic, Scottsdale, Arizona
,
Janis E. Blair
1   Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, Arizona
› Author Affiliations
Further Information

Publication History

Publication Date:
30 January 2020 (online)

Abstract

Coccidioidomycosis is an infection caused by the geographically restricted dimorphic fungus, Coccidioides. Coccidioidomycosis occurs endemically in the southwestern and western United States, mainly in focused regions of Arizona and California where the incidence is highest, and in Central and South America. Patients with impaired immunity, especially those with impaired cellular immunity, are at higher risk of severe and disseminated disease. In this review, we describe the fungal ecology and mycology, epidemiology, pathophysiology, and normal immune defenses to Coccidioides as well as address current concepts in diagnosis, treatment, and continued care of patients with pulmonary coccidioidomycosis. We also present and answer our most frequently asked questions regarding patients with primary pulmonary coccidioidomycosis.

* Co-first authors.


 
  • References

  • 1 Stockamp NW, Thompson III GR. Coccidioidomycosis. Infect Dis Clin North Am 2016; 30 (01) 229-246
  • 2 Fisher FS, Bultman MW, Johnson SM, Pappagianis D, Zaborsky E. Coccidioides niches and habitat parameters in the southwestern United States: a matter of scale. Ann N Y Acad Sci 2007; 1111: 47-72
  • 3 Del Rocío Reyes-Montes M, Pérez-Huitrón MA, Ocaña-Monroy JL. , et al. The habitat of Coccidioides spp. and the role of animals as reservoirs and disseminators in nature. BMC Infect Dis 2016; 16 (01) 550
  • 4 Greene DR, Koenig G, Fisher MC, Taylor JW. Soil isolation and molecular identification of Coccidioides immitis . Mycologia 2000; 92: 406-410
  • 5 Brown J, Benedict K, Park BJ, Thompson III GR. Coccidioidomycosis: epidemiology. Clin Epidemiol 2013; 5: 185-197
  • 6 Cox RA, Magee DM. Coccidioidomycosis: host response and vaccine development. Clin Microbiol Rev 2004; 17 (04) 804-839
  • 7 Rosenthal SR, Routien JB. Contagiousness of coccidioidomycosis; an experimental study. Arch Intern Med (Chic) 1947; 80 (03) 343-357
  • 8 Kohn GJ, Linné SR, Smith CM, Hoeprich PD. Acquisition of coccidioidomycosis at necropsy by inhalation of coccidioidal endospores. Diagn Microbiol Infect Dis 1992; 15 (06) 527-530
  • 9 Gaidici A, Saubolle MA. Transmission of coccidioidomycosis to a human via a cat bite. J Clin Microbiol 2009; 47 (02) 505-506
  • 10 Dierberg KL, Marr KA, Subramanian A. , et al. Donor-derived organ transplant transmission of coccidioidomycosis. Transpl Infect Dis 2012; 14 (03) 300-304
  • 11 Gaab EM, Naeem F. Pediatric coccidioidomycosis patients: perceptions, quality of life and psychosocial factors. Healthcare (Basel) 2015; 3 (03) 775-795
  • 12 Eckmann BH, Schaefer GL, Huppert M. Bedside interhuman transmission of coccidioidomycosis via growth on fomites. An epidemic involving six persons. Am Rev Respir Dis 1964; 89: 175-185
  • 13 Type and duration of precautions recommended for selected infections and conditions. Centers for Disease Control and Prevention, 2019 . Available at: https://www.cdc.gov/infectioncontrol/guidelines/isolation/appendix/type-duration-precautions.html . Accessed August 22, 2019
  • 14 Stevens DA, Clemons KV, Levine HB. , et al. Expert opinion: what to do when there is Coccidioides exposure in a laboratory. Clin Infect Dis 2009; 49 (06) 919-923
  • 15 Saubolle MA, McKellar PP, Sussland D. Epidemiologic, clinical, and diagnostic aspects of coccidioidomycosis. J Clin Microbiol 2007; 45 (01) 26-30
  • 16 Lewis ER, Bowers JR, Barker BM. Dust devil: the life and times of the fungus that causes valley Fever. PLoS Pathog 2015; 11 (05) e1004762
  • 17 Pappagianis D. Marked increase in cases of coccidioidomycosis in California: 1991, 1992, and 1993. Clin Infect Dis 1994; 19 (Suppl. 01) S14-S18
  • 18 Park BJ, Sigel K, Vaz V. , et al. An epidemic of coccidioidomycosis in Arizona associated with climatic changes, 1998-2001. J Infect Dis 2005; 191 (11) 1981-1987
  • 19 Talamantes J, Behseta S, Zender CS. Statistical modeling of valley fever data in Kern County, California. Int J Biometeorol 2007; 51 (04) 307-313
  • 20 Marsden-Haug N, Goldoft M, Ralston C. , et al. Coccidioidomycosis acquired in Washington State. Clin Infect Dis 2013; 56 (06) 847-850
  • 21 Marsden-Haug N, Hill H, Litvintseva AP. , et al; Centers for Disease Control and Prevention (CDC). Coccidioides immitis identified in soil outside of its known range—Washington, 2013. MMWR Morb Mortal Wkly Rep 2014; 63 (20) 450
  • 22 Laniado-Laborín R, Arathoon EG, Canteros C, Muñiz-Salazar R, Rendon A. Coccidioidomycosis in Latin America. Med Mycol 2019; 57 (Suppl. 01) S46-S55
  • 23 Al-Daraji WI, Al-Mahmoud RM, Ali MA. Disseminated coccidioidomycosis: a case report from the United kingdom. Int J Clin Exp Pathol 2009; 2 (05) 494-497
  • 24 Diaz JH. Travel-related risk factors for coccidioidomycosis. J Travel Med 2018; 25 (01) 25
  • 25 Heidi E B, Wangshu M, Mohammed K, Clarisse T, Jian L, Daoqin T. Spatial scale in environmental risk mapping: a Valley fever case study. J Public Health Res 2017; 6 (02) 886
  • 26 Vartivarian SE, Coudron PE, Markowitz SM. Disseminated coccidioidomycosis. Unusual manifestations in a cardiac transplantation patient. Am J Med 1987; 83 (05) 949-952
  • 27 Odio CD, Marciano BE, Galgiani JN, Holland SM. Risk factors for disseminated coccidioidomycosis, United States. Emerg Infect Dis 2017; 23 (02) 23
  • 28 Kimberlin DW, Brady MT, Jackson MA, Long SS. Coccidiodomycosis. Red Book 2018–2021: Report of the Committee on Infectious Diseases. 31st ed. Itasca, IL: American Academy of Pediatrics; 2018: 294-297
  • 29 Sievers ML. Disseminated coccidioidomycosis among southwestern American Indians. Am Rev Respir Dis 1974; 109 (06) 602-612
  • 30 Drutz DJ, Huppert M. Coccidioidomycosis: factors affecting the host-parasite interaction. J Infect Dis 1983; 147 (03) 372-390
  • 31 Ampel NM, Hoover SE. Pathogenesis of coccidioidomycosis. Curr Fungal Infect Rep 2015; 9: 253-258
  • 32 Lee CY, Thompson III GR, Hastey CJ. , et al. Coccidioides endospores and spherules draw strong chemotactic, adhesive, and phagocytic responses by individual human neutrophils. PLoS One 2015; 10 (06) e0129522
  • 33 Castro-Lopez N, Hung CY. Immune response to coccidioidomycosis and the development of a vaccine. Microorganisms 2017; 5 (01) 5
  • 34 Hirschmann JV. The early history of coccidioidomycosis: 1892-1945. Clin Infect Dis 2007; 44 (09) 1202-1207
  • 35 Smith CE, Beard RR. , et al. Varieties of coccidioidal infection in relation to the epidemiology and control of the diseases. Am J Public Health Nations Health 1946; 36 (12) 1394-1402
  • 36 Kim MM, Blair JE, Carey EJ, Wu Q, Smilack JD. Coccidioidal pneumonia, Phoenix, Arizona, USA, 2000-2004. Emerg Infect Dis 2009; 15 (03) 397-401
  • 37 Malo J, Luraschi-Monjagatta C, Wolk DM, Thompson R, Hage CA, Knox KS. Update on the diagnosis of pulmonary coccidioidomycosis. Ann Am Thorac Soc 2014; 11 (02) 243-253
  • 38 Ampel NM. The treatment of coccidioidomycosis. Rev Inst Med Trop São Paulo 2015; 57 (Suppl. 19) 51-56
  • 39 Petersen LR, Marshall SL, Barton-Dickson C. , et al. Coccidioidomycosis among workers at an archeological site, northeastern Utah. Emerg Infect Dis 2004; 10 (04) 637-642
  • 40 Galgiani JN, Ampel NM, Blair JE. , et al; Infectious Diseases Society of America. Coccidioidomycosis. Clin Infect Dis 2005; 41 (09) 1217-1223
  • 41 Jude CM, Nayak NB, Patel MK, Deshmukh M, Batra P. Pulmonary coccidioidomycosis: pictorial review of chest radiographic and CT findings. Radiographics 2014; 34 (04) 912-925
  • 42 Blair JE. Coccidioidal meningitis: update on epidemiology, clinical features, diagnosis, and management. Curr Infect Dis Rep 2009; 11 (04) 289-295
  • 43 Wrobel CJ, Chappell ET, Taylor W. Clinical presentation, radiological findings, and treatment results of coccidioidomycosis involving the spine: report on 23 cases. J Neurosurg 2001; 95 (1, Suppl): 33-39
  • 44 Blair JE. State-of-the-art treatment of coccidioidomycosis skeletal infections. Ann N Y Acad Sci 2007; 1111: 422-433
  • 45 Blair JE. State-of-the-art treatment of coccidioidomycosis: skin and soft-tissue infections. Ann N Y Acad Sci 2007; 1111: 411-421
  • 46 Garcia Garcia SC, Salas Alanis JC, Flores MG, Gonzalez Gonzalez SE, Vera Cabrera L, Ocampo Candiani J. Coccidioidomycosis and the skin: a comprehensive review. An Bras Dermatol 2015; 90 (05) 610-619
  • 47 Zhou S, Ma Y, Chandrasoma P. Small bowel dissemination of coccidioidomycosis. Case Rep Pathol 2015; 2015: 403671
  • 48 Kuntze JR, Herman MH, Evans SG. Genitourinary coccidioidomycosis. J Urol 1988; 140 (02) 370-374
  • 49 Rodenbiker HT, Ganley JP. Ocular coccidioidomycosis. Surv Ophthalmol 1980; 24 (05) 263-290
  • 50 Galgiani JN, Ampel NM, Blair JE. , et al. 2016 Infectious Diseases Society of America (IDSA) Clinical Practice Guideline for the Treatment of Coccidioidomycosis. Clin Infect Dis 2016; 63 (06) e112-e146
  • 51 DiCaudo DJ. Coccidioidomycosis: a review and update. J Am Acad Dermatol 2006; 55 (06) 929-942 , quiz 943–945
  • 52 Galgiani JN. Coccidioidomycosis. West J Med 1993; 159 (02) 153-171
  • 53 Nesbit LA, Knox KS, Nguyen CT. , et al. Immunological characterization of bronchoalveolar lavage fluid in patients with acute pulmonary coccidioidomycosis. J Infect Dis 2013; 208 (05) 857-863
  • 54 Swartz J, Stoller JK. Acute eosinophilic pneumonia complicating Coccidioides immitis pneumonia: a case report and literature review. Respiration 2009; 77 (01) 102-106
  • 55 Zangeneh TT, Malo J, Luraschi-Monjagatta C. , et al. Positive (1-3) B-d-glucan and cross reactivity of fungal assays in coccidioidomycosis. Med Mycol 2015; 53 (02) 171-173
  • 56 Reed WB, Heiskell CL, Holeman CW, Carpenter C. Serum protein profiles in coccidioidomycosis. Calif Med 1962; 97: 333-337
  • 57 Yozwiak ML, Lundergan LL, Kerrick SS, Galgiani JN. Symptoms and routine laboratory abnormalities associated with coccidioidomycosis. West J Med 1988; 149 (04) 419-421
  • 58 Sakata KK, Grys TE, Chang YH, Vikram HR, Blair JE. Serum procalcitonin levels in patients with primary pulmonary coccidioidomycosis. Ann Am Thorac Soc 2014; 11 (08) 1239-1243
  • 59 Vucicevic D, Blair JE, Binnicker MJ. , et al. The utility of Coccidioides polymerase chain reaction testing in the clinical setting. Mycopathologia 2010; 170 (05) 345-351
  • 60 Pappagianis D, Zimmer BL. Serology of coccidioidomycosis. Clin Microbiol Rev 1990; 3 (03) 247-268
  • 61 Blair JE, Mendoza N, Force S, Chang YH, Grys TE. Clinical specificity of the enzyme immunoassay test for coccidioidomycosis varies according to the reason for its performance. Clin Vaccine Immunol 2013; 20 (01) 95-98
  • 62 Grys TE, Brighton A, Chang YH, Liesman R, Bolster LaSalle C, Blair JE. Comparison of two FDA-cleared EIA assays for the detection of Coccidioides antibodies against a composite clinical standard. Med Mycol 2018; (e-pub ahead of print) DOI: 10.1093/mmy/myy094.
  • 63 Blair JE, Coakley B, Santelli AC, Hentz JG, Wengenack NL. Serologic testing for symptomatic coccidioidomycosis in immunocompetent and immunosuppressed hosts. Mycopathologia 2006; 162 (05) 317-324
  • 64 Lindsley MD, Ahn Y, McCotter O. , et al. Evaluation of the specificity of two enzyme immunoassays for coccidioidomycosis by using sera from a region of endemicity and a region of nonendemicity. Clin Vaccine Immunol 2015; 22 (10) 1090-1095
  • 65 Thompson III GR, Lunetta JM, Johnson SM. , et al. Early treatment with fluconazole may abrogate the development of IgG antibodies in coccidioidomycosis. Clin Infect Dis 2011; 53 (06) e20-e24
  • 66 Khan S, Saubolle MA, Oubsuntia T. , et al. Interlaboratory agreement of coccidioidomycosis enzyme immunoassay from two different manufacturers. Med Mycol 2019; 57 (04) 441-446
  • 67 Durkin M, Estok L, Hospenthal D. , et al. Detection of Coccidioides antigenemia following dissociation of immune complexes. Clin Vaccine Immunol 2009; 16 (10) 1453-1456
  • 68 Wack EE, Ampel NM, Sunenshine RH, Galgiani JN. The return of delayed-type hypersensitivity skin testing for coccidioidomycosis. Clin Infect Dis 2015; 61 (05) 787-791
  • 69 Mafi N, Murphy CB, Girardo ME, Blair JE. Coccidioides (spherulin) skin testing in patients with pulmonary coccidioidomycosis in an endemic region. Med Mycol 2019; (e-pub ahead of print) DOI: 10.1093/mmy/myz099.
  • 70 Hartmann CA, Aye WT, Blair JE. Treatment considerations in pulmonary coccidioidomycosis. Expert Rev Respir Med 2016; 10 (10) 1079-1091
  • 71 Catanzaro A, Cloud GA, Stevens DA. , et al. Safety, tolerance, and efficacy of posaconazole therapy in patients with nonmeningeal disseminated or chronic pulmonary coccidioidomycosis. Clin Infect Dis 2007; 45 (05) 562-568
  • 72 Kim MM, Vikram HR, Kusne S, Seville MT, Blair JE. Treatment of refractory coccidioidomycosis with voriconazole or posaconazole. Clin Infect Dis 2011; 53 (11) 1060-1066
  • 73 Ganley KJ, Bosch PR, Blair JE, Rischard F, Galgiani JN. Oxygen consumption deficits in patients with residual fatigue after primary coccidioidomycosis. Open Forum Infect Dis 2017; 4 (03) ofx136
  • 74 Pedersen BK, Saltin B. Exercise as medicine—evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports 2015; 25 (Suppl. 03) 1-72
  • 75 Blair JE, Ampel NM, Hoover SE. Coccidioidomycosis in selected immunosuppressed hosts. Med Mycol 2019; 57 (Suppl. 01) S56-S63
  • 76 Choi K, Deval N, Vyas A. , et al. The utility of screening for coccidioidomycosis in recipients of inhibitors of tumor necrosis factor α. Clin Infect Dis 2019; 68 (06) 1024-1030
  • 77 Blair JE. Coccidioidomycosis in patients who have undergone transplantation. Ann N Y Acad Sci 2007; 1111: 365-376
  • 78 Santelli AC, Blair JE, Roust LR. Coccidioidomycosis in patients with diabetes mellitus. Am J Med 2006; 119 (11) 964-969
  • 79 Keckich DW, Blair JE, Vikram HR, Seville MT, Kusne S. Reactivation of coccidioidomycosis despite antifungal prophylaxis in solid organ transplant recipients. Transplantation 2011; 92 (01) 88-93
  • 80 Bercovitch RS, Catanzaro A, Schwartz BS, Pappagianis D, Watts DH, Ampel NM. Coccidioidomycosis during pregnancy: a review and recommendations for management. Clin Infect Dis 2011; 53 (04) 363-368
  • 81 Labuschagne H, Burns C, Martinez S. , et al. Coccidioidomycosis in pregnancy: case report and literature review of associated placental lesions. Case Rep Womens Health 2016; 12: 5-10
  • 82 Bérard A, Sheehy O, Zhao JP. , et al. Associations between low- and high-dose oral fluconazole and pregnancy outcomes: 3 nested case-control studies. CMAJ 2019; 191 (07) E179-E187
  • 83 Mølgaard-Nielsen D, Svanström H, Melbye M, Hviid A, Pasternak B. Association between use of oral fluconazole during pregnancy and risk of spontaneous abortion and stillbirth. JAMA 2016; 315 (01) 58-67
  • 84 Kahn A, Carey EJ, Blair JE. Universal fungal prophylaxis and risk of coccidioidomycosis in liver transplant recipients living in an endemic area. Liver Transpl 2015; 21 (03) 353-361
  • 85 Blair JE, Chang YH, Cheng MR. , et al. Characteristics of patients with mild to moderate primary pulmonary coccidioidomycosis. Emerg Infect Dis 2014; 20 (06) 983-990
  • 86 Garrett AL, Chang YH, Ganley K, Blair JE. Uphill both ways: fatigue and quality of life in valley fever. Med Mycol 2016; 54 (03) 310-317