Abstract
Purpose of Review
Coccidioidomycosis is a systemic fungal infection endemic in Southwestern United States, Northern Mexico, Central and South America. Coccidioidal infection is not well characterized in pediatric population; but due to an increasing incidence in this age group, a special interest had surged to further describe clinical findings, treatment and clinical course of pediatric patients with coccidioidomycosis.
Recent Findings
In the last few years new data about coccidioidomycosis in children and adolescents has been published, including the report of increasing incidence in general population, making a high index of suspicion among healthcare providers important to avoid delays in diagnosis and treatment.
Summary
This review focuses on coccidioidal infections in pediatric population, emphasizing on the epidemiology, clinical manifestations, natural history, diagnosis and management in children and adolescents.
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References
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• Dimitrova D, Ross L. Coccidioidomycosis: experience from a children’s hospital in an area of endemicity. J Pediatric Infect Dis Soc. 2016;5(1):89–92. https://doi.org/10.1093/jpids/piu091This paper provides further clinical characterization of children with coccidioidomycosis by describing experience with 64 patients from an endemic area.
Brown J, Benedict K, Park BJ, Thompson GR 3rd. Coccidioidomycosis: epidemiology. Clin Epidemiol. 2013;5:185–97. https://doi.org/10.2147/CLEP.S34434.
McCarty JM, Demetral LC, Dabrowski L, Kahal AK, Bowser AM, Hahn JE. Pediatric coccidioidomycosis in central California: a retrospective case series. Clin Infect Dis. 2013;56(11):1579–85. https://doi.org/10.1093/cid/cit114.
Nimer N, Camp T. Coccidioidomycosis. Pediatr Rev. 2015;36(4):181–2. https://doi.org/10.1542/pir.36-4-181.
•• Lee LA, Sondermeyer Cooksey GL, Kim JJ, Kahal A, Gilliss D, Naeem F, et al. Pediatric coccidioidomycosis: case series from a California pediatric infectious diseases clinic. Pediatr Infect Dis J. 2019;38(2):115–21. https://doi.org/10.1097/INF.0000000000002069This paper amply describes clinical findings, diagnosis, and management of coccidioidomycosis in 108 pediatric patients from an endemic area.
• Shehab ZM. Coccidioidomycosis. Adv Pediatr. 2010;57(1):269–86. https://doi.org/10.1016/j.yapd.2010.08.008This paper provides general information of coccidioidomycosis in pediatric population.
Stockamp NW, Thompson GR 3rd. Coccidioidomycosis. Infect Dis Clin N Am. 2016;30(1):229–46. https://doi.org/10.1016/j.idc.2015.10.008.
•• Sondermeyer Cooksey GL, Jain S, Vugia DJ. Epidemiology of coccidioidomycosis among children in California, 2000-2016. Med Mycol. 2019;57(Supplement_1):S64–6. https://doi.org/10.1093/mmy/myy066This paper reports the latest epidemiology data of coccidioidomycosis in the California pediatric population.
•• OZ MC, Benedict K, Engelthaler DM, Komatsu K, Lucas KD, Mohle-Boetani JC, et al. Update on the epidemiology of coccidioidomycosis in the United States. Med Mycol. 2019;57(Supplement_1):S30–40. https://doi.org/10.1093/mmy/myy095This paper provides an update on coccidioidomycosis recent trends and public health efforts nationally and in Arizona, California, and Washington states.
• Benedict K, Ireland M, Weinberg MP, Gruninger RJ, Weigand J, Chen L, et al. Enhanced surveillance for coccidioidomycosis, 14 US states, 2016. Emerg Infect Dis. 2018;24(8):1444–52. https://doi.org/10.3201/eid2408.171595This paper describes the epidemiology, diagnosis, and outcomes of coccidioidomycosis in non-highly endemic states of the USA.
• Luo R, Greenberg A, Stone CD. Hospitalized burden and outcomes of coccidioidomycosis: a nationwide analysis, 2005-2012. Med Mycol. 2017;55(4):368–74. https://doi.org/10.1093/mmy/myw087This paper reviews the outcomes of coccidioidomycosis, such as trends of annual hospitalization, in-hospital mortality, and independent risk factors for mortality.
Forrester JD, Guo HH, Weiser TG. Coccidioidomycosis: surgical issues and implications. Surg Infect. 2016;17(6):645–55. https://doi.org/10.1089/sur.2016.148.
Kirkland TN, Fierer J. Coccidioides immitis and posadasii; a review of their biology, genomics, pathogenesis, and host immunity. Virulence. 2018;9(1):1426–35. https://doi.org/10.1080/21505594.2018.1509667.
Fisher BT, Chiller TM, Prasad PA, Beveridge M, Walsh TJ, Zaoutis TE. Hospitalizations for coccidioidomycosis at forty-one children’s hospitals in the United States. Pediatr Infect Dis J. 2010;29(3):243–7. https://doi.org/10.1097/INF.0b013e3181bcfd7f.
Connelly MB, Zerella JT. Surgical management of coccidioidomycosis in children. J Pediatr Surg. 2000;35(11):1633–4. https://doi.org/10.1053/jpsu.2000.
Chu JH, Feudtner C, Heydon K, Walsh TJ, Zaoutis TE. Hospitalizations for endemic mycoses: a population-based national study. Clin Infect Dis. 2006;42(6):822–5. https://doi.org/10.1086/500405.
• Laniado-Laborín R, Arathoon EG, Canteros C, Muñiz-Salazar R, Rendon A. Coccidioidomycosis in Latin America. Med Mycol. 2019;57(Supplement_1):S46–55. https://doi.org/10.1093/mmy/myy037This paper provides information of coccidioidomycosis in Latin America.
Bonifaz-Trujillo JA. In: Bonifaz-Trujillo JA, editor. Coccidioidomycosis, Micología médica básica: McGraw-Hill; 2015.
Castro-Lopez N, Hung CY. Immune response to coccidioidomycosis and the development of a vaccine. Microorganisms. 2017;5(1):E13. https://doi.org/10.3390/microorganisms5010013.
•• Hung CY, Hsu AP, Holland SM, Fierer J. A review of innate and adaptive immunity to coccidioidomycosis. Med Mycol. 2019;57(Supplement_1):S85–92. https://doi.org/10.1093/mmy/myy146This review discusses features of the immune response and genetic susceptibility toCoccidioidessp. infection.
•• Blair JE, Ampel NM, Hoover SE. Coccidioidomycosis in selected immunosuppressed hosts. Med Mycol. 2019;57(Supplement_1):S56–63. https://doi.org/10.1093/mmy/myy019This paper summarizes the clinical manifestations, diagnosis, treatment, and prevention of coccidioidomycosis in immunosuppressed hosts.
• Odio CD, Marciano BE, Galgiani JN, Holland SM. Risk factors for disseminated coccidioidomycosis, United States. Emerg Infect Dis. 2017;23(2). https://doi.org/10.3201/eid2302.160505This paper reviews the risk factors for disseminated coccidioidomycosis.
Noble JA, Nelson RG, Fufaa GD, Kang P, Shafir SC, Galgiani JN. Effect of geography on the analysis of coccidioidomycosis-associated deaths, United States. Emerg Infect Dis. 2016;22(10):1821–3. https://doi.org/10.3201/eid2210.160696.
•• Naeem F, McCarty J, Mhaissen MN, Ha S, Rongkavilit C. Extrapulmonary coccidioidomycosis among children in Central California: a retrospective review. Pediatr Infect Dis J. 2019;38(12):1189–94. https://doi.org/10.1097/INF.0000000000002470This retrospective review provides good information about the clinical course, diagnostic studies, treatment, and outcomes of 78 children with extrapulmonary coccidioidomycosis.
Garcia Garcia SC, Salas Alanis JC, Flores MG, Gonzalez Gonzalez SE, Vera Cabrera L, Ocampo CJ. Coccidioidomycosis and the skin: a comprehensive review. An Bras Dermatol. 2015;90(5):610–9. https://doi.org/10.1590/abd1806-4841.20153805.
Yeoh DK, Butters C, Curtis N. Endemic mycoses in children. Pediatr Infect Dis J. 2019;38(6S Suppl 1):S52–9. https://doi.org/10.1097/INF.0000000000002324.
Rojas-García OC, Moreno-Treviño MG, Gonzalez-Salazar F, Salas-Alanis JC. Primary cutaneous coccidioidomycosis in an infant. Gac Med Mex. 2014;150(2):175–6.
Abdelmisseh M, Naeem F, Veesenmeyer A, Siongco A, Rongkavilit C. A California infant with insidious left wrist swelling. Pediatr Infect Dis J. 2018;37(6):615. https://doi.org/10.1097/INF.0000000000001858.
Escobedo EV, Ho CH, Homans JD. An 18-year-old man with bilateral violaceous cervical adenopathy. JAMA Pediatr. 2014;168(8):773–4. https://doi.org/10.1001/jamapediatrics.2013.4656.
McHardy IH, Dinh BN, Waldman S, Stewart E, Bays D, Pappagianis D, et al. Coccidioidomycosis complement fixation titer trends in the age of antifungals. J Clin Microbiol. 2018;56(12):e01318. https://doi.org/10.1128/JCM.01318-18.
Gabe LM, Malo J, Knox KS. Diagnosis and management of coccidioidomycosis. Clin Chest Med. 2017;38(3):417–33. https://doi.org/10.1016/j.ccm.2017.04.005.
Brennan-Krohn T, Yoon E, Nishino M, Kirby JE, Riedel S. Arthroconidia in lung tissue: an unusual histopathological finding in pulmonary coccidioidomycosis. Hum Pathol. 2018;71:55–9. https://doi.org/10.1016/j.humpath.2017.07.013.
• Galgiani JN, Ampel NM, Blair JE, Catanzaro A, Geertsma F, Hoover SE, et al. 2016 Infectious Diseases Society of America (IDSA) clinical practice guideline for the treatment of coccidioidomycosis. Clin Infect Dis. 2016;63(6):e112–46. https://doi.org/10.1093/cid/ciw360These revised guidelines provide recommendations for diagnosis and management of coccidioidal infections.
Levy ER, McCarty JM, Shane AL, Weintrub PS. Treatment of pediatric refractory coccidioidomycosis with combination voriconazole and caspofungin: a retrospective case series. Clin Infect Dis. 2013;56(11):1573–8. https://doi.org/10.1093/cid/cit113.
Homans JD, Spencer L. Itraconazole treatment of nonmeningeal coccidioidomycosis in children: two case reports and review of the literature. Pediatr Infect Dis J. 2010;29(1):65–7.
Ho AK, Shrader MW, Falk MN, Segal LS. Diagnosis and initial management of musculoskeletal coccidioidomycosis in children. J Pediatr Orthop. 2014;34(5):571–7. https://doi.org/10.1097/BPO.0000000000000147.
Krogstad P, Johnson R, Garcia-Lloret MI, Heidari A, Butte MJ. Host-pathogen interactions in coccidioidomycosis: prognostic clues and opportunities for novel therapies. Clin Ther. 2019;41(10):1939–1954.e1. https://doi.org/10.1016/j.clinthera.2019.08.011.
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Maria Teresa Garcia-Romero reports personal fees from Pierre Fabre Mexico, personal fees from Sanofi Mexico, and personal fees from Pfizer Mexico outside the submitted work. Mariana Maza-Morales, Marian Kristalia Rivas-Calderón and Elsa Eduwiges Barrón-Calvillo declare no conflicts of interest relevant to this manuscript.
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This article is part of the Topical Collection on Fungal Infections of Skin and Subcutaneous Tissue
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Maza-Morales, M., Rivas-Calderón, M.K., Barrón-Calvillo, E.E. et al. Coccidioidomycosis in Children and Adolescents: an Update. Curr Fungal Infect Rep 14, 106–114 (2020). https://doi.org/10.1007/s12281-020-00381-8
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DOI: https://doi.org/10.1007/s12281-020-00381-8