DANETTA A. BRONNIMANN, M.D.; RODNEY D. ADAM, M.D.; JOHN N. GALGIANI, M.D.; MICHAEL P. HABIB, M.D.; ESKILD A. PETERSEN, M.D.; BRUCE PORTER, M.P.A.; JOHN W. BLOOM, M.D.
Of 27 patients with the acquired immunodeficiency syndrome (AIDS) in Tucson, Arizona, 7 had concurrent coccidioidomycosis. Early manifestations of infection in 6 patients included diffuse nodular pulmonary infiltrates and Coccidioides immitis in many extrathoracic sites. By comparison, a retrospective review of the cases of 300 patients hospitalized with coccidioidal infection identified only 13 patients without AIDS who had the same extent of infection, and only 3 of these patients had no immunosuppressing conditions. Antibodies for coccidioidal antigens at serum dilutions as high as 1:2048 were detected in 5 of the 7 patients with AIDS. Six had temporary responses to amphotericin B treatment, taken both alone and combined with ketoconazole, but all died within 14 months of their diagnosis of coccidioidomycosis. Because annual rates of coccidioidal infection in the Tucson area are 4% or less, the rate of 27% that we calculated, based on 7 patients having the infection during 26 years of risk for AIDS, suggests frequent reactivation of the infection or enhanced susceptibility to endemic exposure in persons with AIDS.
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BRONNIMANN DA, ADAM RD, GALGIANI JN, HABIB MP, PETERSEN EA, PORTER B, et al. Coccidioidomycosis in the Acquired Immunodeficiency Syndrome. Ann Intern Med. 1987;106:372–379. doi: 10.7326/0003-4819-106-3-372
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Published: Ann Intern Med. 1987;106(3):372-379.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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