Hypercalcemia in Disseminated Coccidioidomycosis

Disseminated Coccidioidomycosis

Disseminated Coccidioidomycosis To the Editor: Coccidioidomy-cosis, an infection caused by the dimorphic fungus Coccidioides immi-tis, is endemic in the southwestern United States, parts of Mexico, and Central and South America (1). Patients with C. immitis infection may have chronic pneumonia, fungemia, and extrapulmonary dissemination to skin, bones, meninges, and other body sites. The clinic...

Fluconazole-Associated Hypercalcemia in Patients with Coccidioidomycosis

Fluconazole, voriconazole, and itraconazole may potentiate the hypercalcemic effect of other medications, although to date, triazoles alone have not been linked to hypercalcemia. We describe a case of new-onset hypercalcemia in the setting of high-dose fluconazole that resolved after changing the antifungal regimen. We reviewed our institutional database to assess the frequency of moderate or s...

Posttransplantation disseminated coccidioidomycosis acquired from donor lungs.

A North Carolinian developed fatal coccidioidomycosis immediately after bilateral lung transplantation. The donor had previously traveled to Mexico, and the recipient had no travel history to an area where Coccidioides immitis is endemic. Immunosuppressive therapy of the transplant recipient likely reactivated latent Coccidioides infection in the donor lungs, leading to posttransplant coccidioi...

Natural History of Non-CNS Disseminated Coccidioidomycosis

Risk Factors for Disseminated Coccidioidomycosis, United States

Of 150,000 new coccidioidomycosis infections that occur annually in the United States, ≈1% disseminate; one third of those cases are fatal. Immunocompromised hosts have higher rates of dissemination. We identified 8 patients with disseminated coccidioidomycosis who had defects in the interleukin-12/interferon-γ and STAT3 axes, indicating that these are critical host defense pathways.