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Volume 28, Number 6—June 2022
CME ACTIVITY - Synopsis

Cross-Sectional Study of Clinical Predictors of Coccidioidomycosis, Arizona, USA

Ferris A. RamadanComments to Author , Katherine D. Ellingson, Robert A. Canales, Edward J. Bedrick, John N. Galgiani, and Fariba M. Donovan
Author affiliations: University of Arizona, Tucson, Arizona, USA (F.A. Ramadan, K.D. Ellingson, E.J. Bedrick); George Washington University, Washington, DC, USA (R.A. Canales); University of Arizona College of Medicine–Tucson, Tucson (J.N. Galgiani, F.M. Donovan)

Main Article

Table 2

Characteristics of inpatients and outpatients by confirmed Coccidioides diagnosis in a cross-sectional study of clinical predictors of coccidioidomycosis, Arizona, USA*

Characteristics Outpatient
Inpatient
Total, n = 392 p value
Positive, n = 35 Negative, n = 64 Positive, n = 38 Negative, n = 255 Outpatient Inpatient
Median age, y (range)
57 (24–77)
51 (19–93)

45 (18–83)
58 (18–98)
57 (18–98)
0.534
0.022
Sex, no. (%) 0.289 1.000
F 20 (58.8) 29 (46) 18 (47.4) 123 (48.4) 190 (48.8)
M
14 (41.2)
34 (54)

20 (52.6)
131 (51.6)
199 (51.2)


Race, no. (%) 0.574 0.018
African American 2 (5.9) 4 (6.6) 6 (16.7) 14 (5.6) 26 (6.8)
AI/AN 4 (11.8) 2 (3.3) 2 (5.6) 9 (3.6) 17 (4.5)
Asian 1 (2.9) 2 (3.3) 2 (5.6) 2 (0.8) 7 (1.8)
White 27 (79.4) 52 (85.2) 25 (69.4) 211 (84.7) 315 (82.9)
Unknown
0
1 (1.6)

1 (2.8)
13 (5.2)
15 (3.9)


Ethnicity, no. (%) 0.808 1.000
Hispanic 8 (25.8) 18 (30) 10 (27) 69 (27.6) 105 (27.8)
Non-Hispanic
23 (74.2)
42 (70)

27 (73)
181 (72.4)
273 (72.2)


Median length of endemic residence, y (range)
10 (0–59)
20 (0–88)

19 (0–78)
22 (0–98)
20 (0–98)
0.091
0.331
Immunocompromised, no. (%)† 0.344 0.076
Y 7 (20.6) 20 (31.2) 17 (44.7) 154 (61.1) 198 (51)
N
27 (79.4)
44 (68.8)

21 (55.3)
98 (38.9)
190 (49)


Median length of Illness, d (range)
14 (0–300)
14 (0–5,110)

14 (2–365)
14 (1–8,760)
14 (0–8,760)
0.370
0.972
Symptoms, no. (%)‡
Fatigue 19 (54.3) 39 (60.9) 27 (71.1) 203 (79.9) 288 (73.7) 0.531 0.209
Cough 22 (62.9) 44 (68.8) 26 (68.4) 164 (64.6) 256 (65.5) 0.656 0.718
Fever 12 (34.3) 24 (37.5) 15 (39.5) 128 (50.4) 179 (45.8) 0.829 0.227
Chest pain 13 (37.1) 26 (40.6) 14 (36.8) 82 (32.3) 135 (34.5) 0.831 0.583
Shortness of breath 13 (37.1) 42 (65.6) 25 (65.8) 172 (67.7) 256 (65.5) 0.011 0.853
Headache 9 (25.7) 22 (34.4) 13 (34.2) 116 (45.7) 160 (40.9) 0.497 0.221
Night sweats 15 (42.9) 21 (32.8) 13 (34.2) 104 (40.9) 153 (39.1) 0.384 0.481
Muscle aches 13 (37.1) 28 (43.8) 10 (26.3) 122 (47.8) 163 (41.7) 0.670 0.014
Joint pain 13 (37.1) 14 (21.9) 7 (18.4) 82 (32.1) 126 (32.2) 0.156 0.051
Rash 16 (45.7) 3 (4.7) 11 (28.9) 38 (15) 68 (17.3) <0.001 0.037
Other
11 (31.4)
27 (42.2)

11 (28.9)
74 (29.1)
123 (31.5)
0.388
1.000
Laboratory tests, median (range)
Procalcitonin, ng/mL 0.05 (0.012–0.27) 0.10 (0.05–11.59) 0.11 (0.05–92.34) 0.165 (0.02–198.5) 0.11 (0.02–198.5) <0.001 0.617
C-reactive protein, mg/L 7.40 (0.7–260) 17.5 (0.6–266.3) 46.0 (1.4–170.2) 68.0 (0.6–557) 49.00 (0.6–557) 0.090 0.066
ESR, mm/h 15.0 (5–76) 26.0 (1–145) 45.0 (6.0–122.0) 46.0 (4–145) 41.0 (1–145) 0.222 0.427
Leukocytes, × 103 cells/mm3 9.8 (4.6–14) 8.9 (3.7–26.5) 9.0 (0.3–24.4) 10.0 (0.1–45.4) 9.90 (0.1–45.4) 0.560 0.481
Hemoglobin, g/dL 13.8 (12.4–15.9) 13.3 (6.9–19.7) 12.0 (7.2–17.4) 12.0 (4.8–18) 12.6 (4.8–19.7) 0.163 0.438
Platelet count, × 103/mm3 312.0 (226–457) 238.0 (94–446) 260 (10–520) 239.0 (5–940) 248.0 (5–940) <0.001 0.676
Eosinophil count, × 103/µL 0.39 (0–1.4) 0.1 (0–0.8) 0.2 (0.0–3.0) 0.07 (0.0–4.55) 0.1 (0–4.55) <0.001 0.015
Albumin, g/dL 4.05 (2.5–5) 3.9 (1.9–5) 3.0 (1.4–5.0) 3.1 (0.6–6.4) 3.5 (0.6–6.4) 0.483 0.333
Total protein, g/dL 7.3 (6.2–8.7) 7.3 (5.9–9.3) 7.35 (5.4–9.3) 6.95 (2.5–12.0) 7.05 (2.5–12) 0.747 0.044

*Inpatient participants were recruited from among hospitalized patients; outpatients were recruited from patients in emergency departments and affiliated clinics. Bold text indicates statistical significance. AI/AN, American Indian/Alaskan Native; ESR, erythrocyte sedimentation rate.
†Immunocompromised status was identified as a participant with a weakened immune system at the time of coccidioidomycosis diagnosis, which included participants with type 2 diabetes, HIV/AIDS, lupus, rheumatoid arthritis, or leukemia, and organ transplant recipients and those receiving chemotherapy agents, corticosteroids, and biologic response modifiers. ‡Symptom counts represent the total number of patients reporting the condition.

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Page created: March 21, 2022
Page updated: May 20, 2022
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