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Epidemiology, Disease Transmission, Prevention, and Control
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Transmission of tuberculosis and meningococcal meningitis is by airborne droplets and is facilitated by close contact with an infected person. Coccidioidomycosis, an infectious disease of the lungs caused by the fungus Coccidioides immitis, is found in the soil of semidesert areas of the western hemisphere. Infection is acquired by inhalation of wind blown spores.
Neuroinfectious Diseases
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Jeremy D. Young, Jesica A. Herrick, Scott Borgetti
Coccidioidomycosis is a common systemic fungal infection. The most frequent site of primary infection is the lungs, and subacute pneumonia is often referred to as “valley fever.” However, dissemination is not uncommon, and there may be involvement of the CNS with extrapulmonary disease. It is caused by two species of dimorphic fungi: C. immitis and C. posadasii.
Coccidioides
Published in Rossana de Aguiar Cordeiro, Pocket Guide to Mycological Diagnosis, 2019
Coccidioidomycosis is a neglected disease in South America, and many cases are expected to be misdiagnosis with tuberculosis—an endemic disease in many Latin America countries. In Brazil, an epidemiological link between coccidioidomycosis and hunting armadillos had been extensively described. Handling of Coccidioides cultures requires BSL-3 facilities and well trained personnel. Clinical laboratories in endemic areas should provide at least immunological tests for presumptive diagnosis of coccidioidomycosis.
The molecular immunology of human susceptibility to fungal diseases: lessons from single gene defects of immunity
Published in Expert Review of Clinical Immunology, 2019
Candidiasis was not the only mycosis undergoing genetic dissection. Epidemiologic studies from Kern County, California, in the 1930s, had identified that ‘dark-skinned’ races (i.e. those of Filipino, Hispanic and African-American descent) were 10 to 175 times more likely to develop disseminated coccidioidomycosis relative to Caucasian counterparts living in the same area [39]. Further investigations in the 1970s identified blood group phenotype (and presumably genotype) and histocompatibility antigen (e.g. HLA-A9) as being disproportionately increased in frequency in those with disseminated disease [40]. Whether these antigenic variants are directly involved mechanistically in disease pathogenesis, or whether they reflect the particular demographics of those at-risk, is unclear. Nonetheless, these studies collectively identify that, in both penetrant or complex fashion, natural susceptibility to certain fungal diseases is genetically mediated.
Anti-infective chemoprophylaxis after solid-organ transplantation
Published in Expert Review of Clinical Immunology, 2018
Paul J. Deziel, Raymund Razonable
Coccidioides species can lead to disseminated disease, with an incidence of 1.4–6.9% of SOT recipients in endemic regions [68,69]. Most cases of coccidioidomycosis occur during the first year, either as a result of reactivation of latent infection or primary infection (including donor-derived infection) [70,71]. Because of the morbid outcome of coccidioidomycosis, antifungal prophylaxis is recommended for SOT recipients who reside in endemic regions, those that have positive Coccidioides species serology, and those with a history of previous active coccidioidomycosis [72]. The risk of coccidioidomycosis was significantly high among patients in endemic regions that did not receive antifungal prophylaxis [68]. Fluconazole or itraconazole is recommended for prophylaxis, but other advanced azoles like voriconazole or posaconazole are also active [69,72]. The duration varies depending on the risk of reactivation or potential exposure. In our practice, we provide fluconazole for at least 6 months after transplantation in patients who reside in endemic regions and with documented negative pretransplant coccidioides serology and no history of prior infection [72]. SOT patients with positive coccidioides serology or a history of prior infection receive fluconazole prophylaxis for at least 1 year after transplantation, with consideration to prolonging the duration for those considered clinically as high risk.
Advances in the diagnosis of fungal pneumonias
Published in Expert Review of Respiratory Medicine, 2020
Bryan T. Kelly, Kelly M. Pennington, Andrew H. Limper
Coccidioidomycosis is an infection caused by the endemic fungi Coccidioides immitis and Coccidioides posadasii primarily found in the southwest region of the United States and northwestern Mexico [6]. Pulmonary infection is often asymptomatic or mildly symptomatic presenting similar to community-acquired pneumonia. A small number of patients may develop more severe disseminated infection. Patients at increased risk for disseminated infection include immunocompromised patients, pregnant patients, and those of Filipino and African descent, though reasons behind increased dissemination on a racial basis remain unclear [6].