Coccidioidomycosis as a Common Cause of Community-acquired Pneumonia

作者：Lisa Valdivia, David E. Nix, Mark D. Wright, Elizabeth Lindberg, Timothy R. Fagan, Donald Lieberman, T’Prien Stoffer, Neil M. Ampel, John N. Galgiani · 发表于：Emerging infectious diseases · 年份：2006 · DOI：10.3201/eid1206.060028 · 被引用次数：290 · 研究领域：Fungal Infections and Studies、Inflammasome and immune disorders、Streptococcal Infections and Treatments

The early manifestations of coccidioidomycosis (valley fever) are similar to those of other causes of community-acquired pneumonia (CAP). Without specific etiologic testing, the true frequency of valley fever may be underestimated by public health statistics. Therefore, we conducted a prospective observational study of adults with recent onset of a lower respiratory tract syndrome. Valley fever was serologically confirmed in 16 (29%) of 55 persons (95% confidence interval 16%-44%). Antimicrobial medications were used in 81% of persons with valley fever. Symptomatic differences at the time of enrollment had insufficient predictive value for valley fever to guide clinicians without specific laboratory tests. Thus, valley fever is a common cause of CAP after exposure in a disease-endemic region. If CAP develops in persons who travel or reside in Coccidioides-endemic regions, diagnostic evaluation should routinely include laboratory evaluation for this organism.