Journal Article

Airway Coccidioidomycosis-Report of Cases and Review

Andrea Polesk Polesky, Carl M. Kirsch, Linda S. Snyder, Philip LoBue, Frank T. Kagawa, Brian J. Dykstra, John H. Wehner, Antonino Catanzaro, Neil M. Ampel and David A. Stevens

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue 6, pages 1273-1280
Published in print June 1999 | ISSN: 1058-4838
Published online June 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514778
Airway Coccidioidomycosis-Report of Cases and Review

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Infection due to Coccidioides immitis usually begins in the lungs. Despite the initial pulmonary portal of entry, endotracheal and endobronchial coccidioidomycosis has rarely been described. Since the introduction of fiberoptic bronchoscopy and the AIDS epidemic, more C. immitis lesions of the large airways have been noted. We present data on 38 cases of coccidioidomycosis of the airways, including 6 cases detailed from our own experience and 32 from the literature. Direct infection of the airways (28 cases) is a more common mechanism of airways disease than is erosion into the airways from a lymph node (5 cases). Bronchoscopic findings vary and may show mucosal involvement or intrinsic obstruction. Endotracheal and endobronchial disease is not a self-limited disease and requires antifungal therapy. Disseminated disease in these patients is common. Coccidioidomycosis must be considered in the differential diagnosis of airway pathology.

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

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