Journal Article

Risk Factors for Severe Pulmonary and Disseminated Coccidioidomycosis: Kern County, California, 1995–1996

Nancy E. Rosenstein, Kirt W. Emery, S. Ben Werner, Annie Kao, Royce Johnson, Denise Rogers, Duc Vugia, Arthur Reingold, Ronald Talbot, Brian D. Plikaytis, Bradley A. Perkins and Rana A. Hajjeh

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 5, pages 708-714
Published in print March 2001 | ISSN: 1058-4838
Published online March 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/319203
Risk Factors for Severe Pulmonary and Disseminated Coccidioidomycosis: Kern County, California, 1995–1996

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Surveillance for coccidioidomycosis (CM) and a case-control study for risk factors among adults were conducted in Kern County, California. From January 1995 through December 1996, 905 cases of CM were identified, for an annual incidence of 86 cases per 100,000 population. A total of 380 adults were enrolled in the case-control study: 77 had severe pulmonary disease, 33 had disseminated disease, and 270 control patients had mild disease. Independent risk factors for severe pulmonary disease included diabetes, recent history of cigarette smoking, income of <$15,000 per year, and older age. Oral antifungal therapy before hospitalization was associated with a reduced risk of CM pneumonia. Risk factors for disseminated disease were black race, income of <$15,000 per year, and pregnancy. Early treatment of CM with oral antifungal agents may prevent severe pulmonary disease in groups considered to be at high risk, such as elderly individuals, persons with diabetes, and smokers. Persons at risk for severe CM may benefit from vaccination once an effective CM vaccine is available.

Journal Article.  4353 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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