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Volume 14, Number 7—July 2008

Research

Testing for Coccidioidomycosis among Patients with Community-Acquired Pneumonia

Douglas C. Chang*Comments to Author , Shoana Anderson†, Kathleen Wannemuehler*, David M. Engelthaler†, Laura Erhart†, Rebecca H. Sunenshine†, Lauren A. Burwell*, and Benjamin J. Park*
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Arizona Department of Health Services, Phoenix, Arizona, USA;

Main Article

Table 2

Demographic and clinical characteristics of patients with community-acquired pneumonia included in retrospective cohort studies, Maricopa County, Arizona, January 2003–December 2004*

Patient characteristic System A (% or range), 
n = 66 System B (% or range), 
n = 87 Absolute difference in percentages (95% CI)*
Evaluated initially in emergency department 17 (26) 5 (6) 20 (7–33)†
Median age, y (range) 54 (6–90) 37 (0–86)
Age <18 y 7 (11) 32 (37) 26 (12–39)†
Male 30 (46) 47 (54) NS
Median no. days of symptoms before 1st visit 8 (1–30) 7 (1–60) NS
Symptoms for >21 d at time of 1st visit
4 (9)
6 (7)
NS
Symptoms
Fever 22 (33) 50 (58) NS
Chills 5 (8) 12 (14) NS
Night sweats 0 4 (5) NS
Myalgias 2 (3) 3 (3) NS
Fatigue 4 (6) 4 (5) NS
Cough 54 (82) 69 (79) NS
Dyspnea 18 (27) 23 (26) NS
Chest pain 10 (15) 11 (13) NS
Wheezing
8 (12)
9 (10)
NS
Signs
Temperature >100.4°F 10 (15) 24 (28) NS
Tachycardia 8 (12) 11 (13) NS
Focal lung examination 37 (56) 44 (51) NS
Hypoxia 0 0 NS
Rash
0
0
NS
Immunosuppressive medication
2 (3)
1 (1)
NS
Coexisting conditions
Asthma 10 (15) 23 (26) NS
Chronic obstructive pulmonary disease 13 (20) 12 (14) NS
Diabetes mellitus 25 (38) 7 (8) 30 (16–43)†
HIV infection 0 1 (1) NS
Pregnancy 1 (2) 0 NS
Transplant 1 (2) 0 NS
Malignancy
1 (2)
3 (3)
NS
Diagnostic testing, noncoccidioidal
Chest radiograph 23 (35) 83 (95) 61 (47–72)†
Radiographically proven pneumonia
18 (27)
67 (83)
50 (35–63)†
Treatment and outcome
Antibacterial drugs 66 (100) 87 (100) NS
Follow-up visits
None 17 (26) 27 (31) NS
1 34 (52) 27 (31) NS
2 5 (8) 13 (15) NS
>3 10 (15) 20 (23) NS
Hospital admissions 2 (3) 6 (7) NS
Died
0 (0)
2 (2)
NS
Coccidioides spp. serologic testing
At any visit 1 (2) 11 (13) 11 (3–20)‡
During follow-up visit 0 4 (5) NS
Reactive results 0 1 (1) NS
Median no. days before testing 12 27 (1–99)
Symptoms >14 days before testing 0 7 (64) NS
Diagnosis of coccidioidomycosis, any technique 0 1 (1) NS

CI, confidence interval; NS, not significant. CIs on difference in percentages were performed by using an exact method with 2 independent binomial proportions.
†p<0.01.
‡p<0.05.

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