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Volume 23, Number 2—February 2017
CME ACTIVITY - Dispatch

Risk Factors for Disseminated Coccidioidomycosis, United States

Camila D. Odio1, Beatriz E. Marciano, John N. Galgiani, and Steven M. HollandComments to Author 
Author affiliations: National Institutes of Health, Bethesda, Maryland, USA (C.D. Odio, B.E. Marciano, S.M. Holland); University of Arizona College of Medicine, Tucson, Arizona, USA (J.N. Galgiani)

Main Article

Table 2

Patients with disseminated coccidioidomycosis and discrete primary immune deficiencies*

Patient no. (ref)
Age, y/sex
Race/
ethnicity
Medical history
Extrapulmonary disease
Relapse
Method of diagnosis
Genetic findings
1
4/F
White
HIES, recurrent pneumonia and otitis, skin infections, eczema, thrush
Meningitis
No
BAL/CSF cultures
STAT3: heterozygous (c.2137G>A)
2 (9)
17/F
Not reported
HIES, Staphylococcus. aureus skin and soft tissue infections, recurrent sinus infections, pneumonia
Meningitis, cerebral abscess
No
Coccidioides Ab, CSF culture
STAT3: heterozygous (p.T412S)
3 (10)
11/M
White
11 mo: Mycobacterium chelonei pneumonia 22 y; disseminated M. kansasii
Osteomyelits, lymphadenitis
Yes
Coccidioides Ab level, lymph node biopsy
IFN-γR1: deficiency (c.818del4fs)
4 (11)†
22/F
Palestinian
11 y: Salmonella serogroup D lymphadenitis
Diffuse lymphadenitis
Yes
Coccidioides IgM and IgG, lymph node biopsy
IL-12Rβ1: homozygous (p.C186Y)
5 (11)
6/M
Palestinian
No other significant history
Osteomyelitis, lymphadenitis, nasal lesion,
Yes
Lymph node, nasal lesion, bone biopsies
IL-12Rβ1: homozygous (p.C186Y)
6
15/M
Black
No other significant history
Osteomyelitis, soft tissue
Yes
BAL cultures, bone and soft biopsies
IL-12Rβ2: heterozygous (p.C101Y)
7 (12)
17/F
Hispanic
14 y: extensive, persistent tinea capitis and kerion caused by Trichophyton tonsurans
Osteomyelitis, soft tissue, cutaneous lesions
Yes
Coccidioides Ab, skin biopsy
STAT1: gain of function mutation
(p.E353K)
8 (12) 9.5/F White No other significant history Osteomyelitis, cerebral lesions, intrathoracic lymphadenitis Yes Coccidioides Ab STAT1: gain of function mutation (p.A267V)

*Ab, antibody; BAL, bronchoalveolar lavage; CSF, cerebrospinal fluid; HIES, hyperimmunoglobulin E (Job’s) syndrome; ref, reference.
†Patients 4 and 5 are siblings, and their parents are first cousins.

Main Article

References
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Main Article

1Current affiliation: Yale–New Haven Hospital, New Haven, Connecticut, USA.

Page created: January 12, 2017
Page updated: January 12, 2017
Page reviewed: January 12, 2017
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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