Coccidioidomycosis natural history: Difference between revisions
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{{Coccidioidomycosis}} | {{Coccidioidomycosis}} | ||
== | ===Natural History=== | ||
Coccidioidomycosis is usually a self-limited mild clinical illness. A large proportion of individuals are clinically infected without any manifestations and are thus completely asymptomatic. The remaining develop a mild pulmonary illness which in most cases is self limited requiring no treatment, and even those cases which do require treatment have an excellent prognosis. It is often misdiagnosed as [[community-acquired pneumonia]]. There are several cutaneous manifestations such as [[erythema multiforme]] and [[erythema nodosum]], it may even cause [[arthritis]] and [[arthralgias]]. | *Coccidioidomycosis is usually a self-limited mild clinical illness. | ||
*A large proportion of individuals are clinically infected without any manifestations and are thus completely asymptomatic. | |||
*The remaining develop a mild pulmonary illness which in most cases is self limited requiring no treatment, and even those cases which do require treatment have an excellent prognosis. | |||
*It is often misdiagnosed as [[community-acquired pneumonia]]. There are several cutaneous manifestations such as [[erythema multiforme]] and [[erythema nodosum]], it may even cause [[arthritis]] and [[arthralgias]]. | |||
*If left untreated in patients with weakened immune systems,the infection spreads throughout the body. | |||
*The disseminated form of ''Coccidioidomycosis'' can devastate the body, causing skin ulcers, [[abscess]]es, bone lesions, swollen joints with severe pain, heart inflammation, [[urinary tract]] problems, and [[meningitis|inflammation of the brain's lining]], which can lead to death.<ref>Galgiani J. N. Coccidioidomycosis. In: Cecil, Russell L., Lee Goldman, and D. A. Ausiello. Cecil Medicine. Philadelphia: Saunders Elsevier, 2007.</ref> | |||
==Complications== | ==Complications== | ||
Complications of [[coccidioidomycosis]] include:<ref name="Angelo-">{{Cite journal | last1 = Angelo | first1 = KM. | last2 = Nnedu | first2 = ON. | title = Rare manifestations of coccidioidomycosis. | journal = J La State Med Soc |volume = 165 | issue = 3 | pages = 137-9 | month = | year = | doi = | PMID = 24015425 }}</ref><ref name="Remesar-">{{Cite journal | last1 = Remesar | first1 = MC. | last2 = Blejer | first2 = JL. | last3 = Negroni | first3 = R. | last4 = Nejamkis | first4 = MR. | title = Experimental coccidioidomycosis in the immunosuppressed rat. | journal = Rev Inst Med Trop Sao Paulo | volume = 34 | issue = 4 | pages = 303-7 | month = | year = | doi = | PMID = 1342086 }}</ref> | |||
* [[Pleural effusion]] | * [[Pleural effusion]] | ||
* Return of the infection ([[relapse]] | * Return of the infection ([[relapse]] | ||
| Line 20: | Line 18: | ||
* [[Synovitis]] and [[Osteomyelitis]]. | * [[Synovitis]] and [[Osteomyelitis]]. | ||
===Prognosis=== | |||
Factors associated with increased risk of more severe disease include the following: | |||
*HIV disease,with low CD4 count (<250) | |||
*Late stage Pregnancy( third trimester) | |||
*Organ transplantation | |||
*Immunosuppresant therapy such as tumor necrosis factor (TNF)-alpha inhibitors | |||
<ref name="pmid15188373">{{cite journal |vauthors=Bergstrom L, Yocum DE, Ampel NM, Villanueva I, Lisse J, Gluck O, Tesser J, Posever J, Miller M, Araujo J, Kageyama DM, Berry M, Karl L, Yung CM |title=Increased risk of coccidioidomycosis in patients treated with tumor necrosis factor alpha antagonists |journal=Arthritis Rheum. |volume=50 |issue=6 |pages=1959–66 |year=2004 |pmid=15188373 |doi=10.1002/art.20454 |url=}}</ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 19:47, 9 March 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Vidit Bhargava, M.B.B.S [2]
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Natural History
- Coccidioidomycosis is usually a self-limited mild clinical illness.
- A large proportion of individuals are clinically infected without any manifestations and are thus completely asymptomatic.
- The remaining develop a mild pulmonary illness which in most cases is self limited requiring no treatment, and even those cases which do require treatment have an excellent prognosis.
- It is often misdiagnosed as community-acquired pneumonia. There are several cutaneous manifestations such as erythema multiforme and erythema nodosum, it may even cause arthritis and arthralgias.
- If left untreated in patients with weakened immune systems,the infection spreads throughout the body.
- The disseminated form of Coccidioidomycosis can devastate the body, causing skin ulcers, abscesses, bone lesions, swollen joints with severe pain, heart inflammation, urinary tract problems, and inflammation of the brain's lining, which can lead to death.[1]
Complications
Complications of coccidioidomycosis include:[2][3]
- Pleural effusion
- Return of the infection (relapse
- Meningitis
- Pulmonary cavities, that may rupture leading to pyopneumothroax, otherwise causing persistent cough, hemoptysis, and pleuritic chest pain.
- Synovitis and Osteomyelitis.
Prognosis
Factors associated with increased risk of more severe disease include the following:
- HIV disease,with low CD4 count (<250)
- Late stage Pregnancy( third trimester)
- Organ transplantation
- Immunosuppresant therapy such as tumor necrosis factor (TNF)-alpha inhibitors
References
- ↑ Galgiani J. N. Coccidioidomycosis. In: Cecil, Russell L., Lee Goldman, and D. A. Ausiello. Cecil Medicine. Philadelphia: Saunders Elsevier, 2007.
- ↑ Angelo, KM.; Nnedu, ON. "Rare manifestations of coccidioidomycosis". J La State Med Soc. 165 (3): 137–9. PMID 24015425.
- ↑ Remesar, MC.; Blejer, JL.; Negroni, R.; Nejamkis, MR. "Experimental coccidioidomycosis in the immunosuppressed rat". Rev Inst Med Trop Sao Paulo. 34 (4): 303–7. PMID 1342086.
- ↑ Bergstrom L, Yocum DE, Ampel NM, Villanueva I, Lisse J, Gluck O, Tesser J, Posever J, Miller M, Araujo J, Kageyama DM, Berry M, Karl L, Yung CM (2004). "Increased risk of coccidioidomycosis in patients treated with tumor necrosis factor alpha antagonists". Arthritis Rheum. 50 (6): 1959–66. doi:10.1002/art.20454. PMID 15188373.