Coccidioidomycosis in Renal Replacement Therapy

doi:10.1001/archinte.1982.00340160069017

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Vol. 142 No. 3, March 1982

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Coccidioidomycosis in Renal Replacement Therapy

Irvin M. Cohen, MD; John N. Galgiani, MD; Daniel Potter, MD; David A. Ogden, MD

Arch Intern Med. 1982;142(3):489-494.

Abstract

The potential risk of coccidioidomycosis has led to concernabout the advisability of maintaining renal transplantationprograms in endemic areas. We reviewed the charts of 721 patientsundergoing dialysis and 260 renal transplant recipients in Arizonato determine the incidence, risk factors, and clinical courseof coccidioidomycosis in these immunosuppressed populations.Symptomatic infection occurred in six (0.8%) patients undergoingdialysis and 18 (6.9%) transplant recipients. Male sex and bloodtype B predisposed to dissemination. Urine cultures for funguswere important diagnostic aids. Four of six patients with infectionlimited to the thorax and five of 18 patients with disseminationremained alive after seven months to 7 1/2 years. Although therate of dissemination (75%) and mortality (63%) from coccidioidomycosiswere high, the incidence of infection was low and does not precluderenal transplantation in Arizona. Those who have received transplantselsewhere should be advised not to move to or visit areas endemicfor coccidioidomycosis.

(Arch Intern Med 1982;142:489-494)

Author Affiliations

From the Departments of Medicine, University of Arizona College of Medicine, Tucson, and Tucson (Ariz) Veterans Administration Medical Center (Drs Cohen, Galgiani, and Ogden); and Good Samaritan Hospital of Phoenix (Ariz) (Dr Potter). Dr Cohen is now with Doctor's Hospital, Phoenix, Ariz.

Footnotes

Accepted for publication June 8, 1981.

Reprint requests to Doctor's Hospital, 1947 E Thomas Rd, Phoenix,AZ 85016 (Dr Cohen).

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