 |
|
Coccidioidomycosis in Patients With Hematologic Malignancies
Janis E. Blair, MD;
Jerry D. Smilack, MD;
Sean M. Caples, DO
Arch Intern Med. 2005;165:113-117.
Background An endemic fungal infection of the desert southwestern United States, coccidioidomycosis is generally a self-limited illness in healthy persons. Immunosuppressed persons who contract coccidioidomycosis, however, are at increased risk for disseminated infection.
Methods We conducted a retrospective review of patients with coccidioidomycosis and hematologic malignancy or bone marrow disease.
Results Fifty-five patients were identified. The most common underlying malignancies were non-Hodgkin lymphoma and chronic lymphocytic leukemia. Extrathoracic (or disseminated) infection was observed in 12 patients (22%). Fifteen patients (27%) died with active coccidioidomycosis. Treatment of the hematologic disease with corticosteroids or antineoplastic chemotherapy increased the risk of death.
Conclusion To date, this is the largest case series of patients with hematologic malignancy and coccidioidomycosis. In persons with hematologic malignancy, coccidioidomycosis can be a severe illness with a high risk for disseminated infection and death.
Author Affiliations: Division of Infectious Diseases, Mayo Clinic, Scottsdale, Ariz (Drs Blair and Smilack), and Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minn (Dr Caples) .
|
