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Clinical Observation |

Coccidioidomycosis in Patients With Hematologic Malignancies

Janis E. Blair, MD; Jerry D. Smilack, MD; Sean M. Caples, DO
Arch Intern Med. 2005;165(1):113-117. doi:10.1001/archinte.165.1.113.
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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.

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