Abstract：
BACKGROUND: Coccidioidomycosis is a systemic fungal disease endemic to arid regions of the Western Hemisphere. In the south-western US, Coccidioides spp. may account for up to 20%-25% of all cases of community acquired pneumonia. Clinical manifestations vary widely, from asymptomatic infection to life-threatening disease, especially in immunocompromised hosts.
OBJECTIVE: The primary objective of the study was to characterise cases of coccidioidomycosis in an area of the United States not considered traditionally endemic for the disease.
METHODS: We performed a single-centre retrospective study of all cases of coccidioidomycosis from 1 January 2000 to 31 December 2020, in the University of Oklahoma Health Sciences Medical Center.
RESULTS: A total of 26 patients were included for analysis. The central nervous system (CNS) and the lungs were the sites most frequently involved. Twenty (77%) had travelled to a coccidioidomycosis endemic region. Most were male (81%) with a median age of 42 years (range: 3-78 years). The majority (46%) were Caucasians, 19% were African American, 19% Hispanic, and 12% Native American. The most common comorbidities were diabetes mellitus and acquired immunodeficiency syndrome, identified in 27% and 23% of patients, respectively. Patients on immunosuppressive therapy accounted for 12% of all cases.
CONCLUSIONS: Our study is one of the largest single-centre case series of coccidioidomycosis from a non-endemic area. Diabetes mellitus was the most frequent comorbidity. Compared to other case series of coccidioidomycosis, our patient population had higher rates of immunosuppression and had both a higher rate of disseminated disease and overall mortality.
OBJECTIVE: The primary objective of the study was to characterise cases of coccidioidomycosis in an area of the United States not considered traditionally endemic for the disease.
METHODS: We performed a single-centre retrospective study of all cases of coccidioidomycosis from 1 January 2000 to 31 December 2020, in the University of Oklahoma Health Sciences Medical Center.
RESULTS: A total of 26 patients were included for analysis. The central nervous system (CNS) and the lungs were the sites most frequently involved. Twenty (77%) had travelled to a coccidioidomycosis endemic region. Most were male (81%) with a median age of 42 years (range: 3-78 years). The majority (46%) were Caucasians, 19% were African American, 19% Hispanic, and 12% Native American. The most common comorbidities were diabetes mellitus and acquired immunodeficiency syndrome, identified in 27% and 23% of patients, respectively. Patients on immunosuppressive therapy accounted for 12% of all cases.
CONCLUSIONS: Our study is one of the largest single-centre case series of coccidioidomycosis from a non-endemic area. Diabetes mellitus was the most frequent comorbidity. Compared to other case series of coccidioidomycosis, our patient population had higher rates of immunosuppression and had both a higher rate of disseminated disease and overall mortality.
摘要：
背景：球孢子菌病是西半球干旱地区特有的系统性真菌病。在美国西南部,球虫属。可能占所有社区获得性肺炎病例的20%-25%。临床表现差异很大，从无症状感染到危及生命的疾病，尤其是在免疫受损的宿主中。
目的：本研究的主要目的是描述美国地区球虫孢子菌病的病例特征。
方法：我们对2000年1月1日至2020年12月31日在俄克拉荷马大学健康科学医学中心的所有球孢子菌病病例进行了单中心回顾性研究。
结果：共纳入26例患者进行分析。中枢神经系统（CNS）和肺是最常见的受累部位。20人（77％）曾前往球虫菌病流行区。大多数为男性（81％），中位年龄为42岁（范围：3-78岁）。大多数（46%）是白种人，19%是非洲裔美国人,19%的西班牙裔,和12％的美洲原住民。最常见的合并症是糖尿病和获得性免疫缺陷综合征，在27%和23%的患者中发现，分别。接受免疫抑制治疗的患者占所有病例的12％。
结论：我们的研究是来自非流行区的最大单中心球孢子菌病病例系列之一。糖尿病是最常见的合并症。与其他一系列球孢子菌病相比，我们的患者人群有较高的免疫抑制率,疾病播散率和总死亡率均较高.
目的：本研究的主要目的是描述美国地区球虫孢子菌病的病例特征。
方法：我们对2000年1月1日至2020年12月31日在俄克拉荷马大学健康科学医学中心的所有球孢子菌病病例进行了单中心回顾性研究。
结果：共纳入26例患者进行分析。中枢神经系统（CNS）和肺是最常见的受累部位。20人（77％）曾前往球虫菌病流行区。大多数为男性（81％），中位年龄为42岁（范围：3-78岁）。大多数（46%）是白种人，19%是非洲裔美国人,19%的西班牙裔,和12％的美洲原住民。最常见的合并症是糖尿病和获得性免疫缺陷综合征，在27%和23%的患者中发现，分别。接受免疫抑制治疗的患者占所有病例的12％。
结论：我们的研究是来自非流行区的最大单中心球孢子菌病病例系列之一。糖尿病是最常见的合并症。与其他一系列球孢子菌病相比，我们的患者人群有较高的免疫抑制率,疾病播散率和总死亡率均较高.
