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Volume 32, Number 5—May 2026

CME ACTIVITY - Research

Frequency and Duration of Diagnostic Delays Associated with Coccidioidomycosis and Risk Factors for Missed Diagnoses, United States

Desmond D. Barber, Alan T. Arakkal, George R. Thompson, John W. Baddley, Joe E. Cavanaugh, Aaron C. Miller, and Philip M. PolgreenComments to Author 
Author affiliation: University of Iowa College of Medicine, Iowa City, Iowa, USA (D.D. Barber, A.T. Arakkal, J.E. Cavanaugh, A.C. Miller, P.M. Polgreen); University of California, Davis, California, USA (G.R. Thompson); Johns Hopkins University, Baltimore, Maryland, USA (J.W. Baddley)

Main Article

Figure 3

Number of patients with an outpatient antibiotic prescription or SSD visit each day before the index coccidioidomycosis diagnosis in study of frequency and duration of diagnostic delays associated with coccidioidomycosis and risk factors for missed diagnoses, United States. For comparison, both series have been minimum–maximum normalized between 0 and 1 to enable comparison of their trends; see Appendix Figure2 or raw counts of antibiotics before diagnosis. The trend in SSD visits and outpatient antibiotics exhibit a nearly identical pattern before diagnosis, with a similar increase occurring around 90 days before diagnosis. Those trends suggest an increase in unnecessary antibiotics prescribed in response to undiagnosed coccidioidomycosis symptoms before diagnosis. SSD, symptomatically similar diagnosis.

Figure 3. Number of patients with an outpatient antibiotic prescription or SSD visit each day before the index coccidioidomycosis diagnosis in study of frequency and duration of diagnostic delays associated with coccidioidomycosis and risk factors for missed diagnoses, United States. For comparison, both series have been minimum–maximum normalized between 0 and 1 to enable comparison of their trends; see Appendix Figure2 or raw counts of antibiotics before diagnosis. The trend in SSD visits and outpatient antibiotics exhibit a nearly identical pattern before diagnosis, with a similar increase occurring around 90 days before diagnosis. Those trends suggest an increase in unnecessary antibiotics prescribed in response to undiagnosed coccidioidomycosis symptoms before diagnosis. SSD, symptomatically similar diagnosis.

Main Article

Page created: March 23, 2026
Page updated: May 11, 2026
Page reviewed: May 11, 2026
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