Volume 14, Number 7—July 2008
Research
Testing for Coccidioidomycosis among Patients with Community-Acquired Pneumonia
Douglas C. Chang*
, Shoana Anderson†, Kathleen Wannemuehler*, David M. Engelthaler†, Laura Erhart†, Rebecca H. Sunenshine†, Lauren A. Burwell*, and Benjamin J. Park*
, Shoana Anderson†, Kathleen Wannemuehler*, David M. Engelthaler†, Laura Erhart†, Rebecca H. Sunenshine†, Lauren A. Burwell*, and Benjamin J. Park*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.
