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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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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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