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Coccidioidal Arthritis

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Infections and the Rheumatic Diseases
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Abstract

Coccidioidomycosis is caused in humans by the dimorphic fungi Coccidioides immitis and Coccidioides posadasii, which are distributed in dry and hot areas with low levels of rainfall, such as the southwestern United States and some areas of Mexico and South America. Coccidioidomycosis, also known as San Joaquin Fever or Valley Fever, is a true concern in patients from endemic areas and is responsible for up to 30% of the cases of community-acquired pneumonia in these populations.

Patients with immunosuppression (rheumatic diseases, transplantation, and oncologic treatments), VIH, diabetes, pregnancy, and certain ethnic groups have a greater risk of severe disseminated infection. New aspects about epidemiology, pathophysiology, and disseminated infection with emphasis on musculoskeletal involvement, diagnostic techniques, and treatment are discussed in this chapter.

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References

  1. Sharpton TJ, Stajich JE, Rounsley SD, et al. Comparative genomic analyses of the human fun-gal pathogens Coccidioides and their relatives. Genome Res. 2009;19(10):1722–31.

    Article  CAS  Google Scholar 

  2. Brown J, Benedict K, Park BJ, Thompson GR III. Coccidioidomycosis: epidemiology. Clin Epidemiol. 2013;5:185–97.

    PubMed  PubMed Central  Google Scholar 

  3. Blair JE. State of the art treatment of coccidioidomycosis skeletal infections. Ann N Y Acad Sci. 2007;1111:422–33.

    Article  Google Scholar 

  4. Saubolle MA, McKellar PP, Sussland D. Epidemiologic, clinical, and diagnostic aspects of coccidioidomycosis. J Clin Microbiol. 2007;45(1):26–30.

    Article  CAS  Google Scholar 

  5. Stockamp NW, Thompson GR 3rd. Coccidioidomycosis. Infect Dis Clin N Am. 2016;30(1):229–46.

    Article  Google Scholar 

  6. Twarog M, Thompson GR 3rd. Coccidioidomycosis: recent updates. Semin Respir Crit Care Med. 2015;36(5):746–55.

    Article  Google Scholar 

  7. Centers for Disease Control and Prevention (CDC). Increase in reported coccidioidomycosis--United States, 1998-2011. MMWR Morb Mortal Wkly Rep. 2013;62(12):217–21.

    Google Scholar 

  8. Stevens DA. Coccidioidomycosis. N Engl J Med. 1995;332(16):1077–82.

    Article  CAS  Google Scholar 

  9. Colombo AL, Tobón A, Restrepo A, Queiroz-Telles F, Nucci M. Epidemiology of endemic systemic fungal infections in Latin America. Med Mycol. 2011;49(8):785–98.

    PubMed  Google Scholar 

  10. Hirschmann JV. The early history of coccidioidomycosis: 1892-1945. Clin Infect Dis. 2007;44(9):1202–7.

    Article  Google Scholar 

  11. Petersen LR, Marshall SL, Barton-Dickson C, et al. Coccidioidomycosis among workers at an archeological site, northeastern Utah. Emerg Infect Dis. 2004;10(4):637–42.

    Article  Google Scholar 

  12. Valdivia L, Nix D, Wright M, Lindberg E, Fagan T, Lieberman D, et al. Coccidioidomycosis as a common cause of community-acquired pneumonia. Emerg Infect Dis. 2006;12(6):958–62.

    Article  Google Scholar 

  13. 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.

    Article  PubMed  Google Scholar 

  14. Kirkland TN, Fierer J. Coccidioides immitis and posadasii; a review of their biology, genomics, pathogenesis, and host immunity. Virulence. 2018;9(1):1426–35.

    Article  CAS  Google Scholar 

  15. Louie L, Ng S, Hajjeh R, Johnson R, et al. Influence of host genetics on the severity of coccidioidomycosis. Emerg Infect Dis. 1999;5(5):672–80.

    Article  CAS  Google Scholar 

  16. Rosenstein NE, Emery KW, Werner SB, et al. Risk factors for severe pulmonary and disseminated coccidioidomycosis: Kern County, California; 1995-1996.

    Google Scholar 

  17. Rutala PJ, Smith JW. Coccidioidomycosis in potentially compromised hosts: the effect of immunosuppressive therapy in dissemination. Am J Med Sci. 1978;275(3):283–95.

    Article  CAS  Google Scholar 

  18. Bercovitch RS, Catanzaro A, Schwartz BS, et al. Coccidioidomycosis during pregnancy: a review and recommendations for management. Clin Infect Dis. 2011;53(4):363–8.

    Article  Google Scholar 

  19. Santelli AC, Blair JE, Roust LR. Coccidioidomycosis in patients with diabetes mellitus. Am J Med. 2006;119(11):964–9.

    Article  Google Scholar 

  20. Frey CL, Drutz DJ. Influence of fungal surface components on the interaction of Coccidioides immitis with polymorphonuclear neutrophils. J Infect Dis. 1986;153:933–43.

    Article  CAS  Google Scholar 

  21. Nesbit LA, Knox KS, Nguyen CT, Roesch J, et al. Immunological characterization of bronchoalveolar lavage fluid in patients with acute pulmonary coccidioidomycosis. J Infect Dis. 2013;208(5):857–63.

    Article  CAS  Google Scholar 

  22. Merchant M, Romero AO, Libke RD, et al. Pleural effusion in hospitalized patients with coccidioidomycosis. Respir Med. 2008;102(4):537–40.

    Article  Google Scholar 

  23. Crum-Cianflone NF, Truett AA, Teneza-Mora N, et al. Unusual presentations of coccidioi-domycosis: a case series and review of the literature. Medicine (Baltimore). 2006;85(5):263–77.

    Article  Google Scholar 

  24. Bisla RS, Taber TH Jr. Coccidioidomycosis of bone and joints. Clin Orthop Relat Res. 1976;121:196–204.

    Google Scholar 

  25. Zeppa MA, Laorr A, Greenspan A, McGahan JP, Steinbach LS. Skeletal coccidioidomycosis: imaging findings in 19 patients. Skelet Radiol. 1996;25(4):337–43.

    Article  CAS  Google Scholar 

  26. Chiller TM, Galgiani JN, Stevens DA. Coccidioidomycosis. Infect Dis Clin N Am. 2003;17:41–57.

    Article  Google Scholar 

  27. Reid GD, Klinkhoff A, Bozek C, Denegri JF. Coccidioidomycosis tenosynovitis: case report and review of the literature. J Rheumatol. 1984;11(3):392–4.

    CAS  PubMed  Google Scholar 

  28. McGwire B, Marr B, Zhou XP, Ayers L. Iliopsoas coccidioidomycotic abscess with associated intra-abdominal extension in an immunocompetent patient. BMJ Case Rep. 2012;2012:bcr2012007436.

    Article  Google Scholar 

  29. Szeyko LA, Taljanovic MS, Dzioba RB, et al. Vertebral coccidioidomycosis: presentation and multidisciplinary management. Am J Med. 2012;125:304–14.

    Article  Google Scholar 

  30. Galgiani JN, Ampel NM, Blair JE, et al. Infectious Diseases Society of America (IDSA) clinical practice guideline for the treatment of coccidioidomycosis. Clin Infect Dis. 2016;63(6):e112–46.37.

    Article  Google Scholar 

  31. Dewsnup DH, Galgiani JN, Graybill JR, et al. Is it ever safe to stop azole therapy for Coccidioides immitis meningitis? Ann Intern Med. 1996;124(3):305–10.

    Article  CAS  Google Scholar 

  32. Blair JE. State of the art treatment of coccidioidomycosis: skin and soft-tissue infections. Ann N Y Acad Sci. 2007;1111:411–21.

    Article  Google Scholar 

  33. Garcia Garcia SC, Salas Alanis JC, Flores MG, et al. Coccidioidomycosis and the skin: a comprehensive review. An Bras Dermatol. 2015;90(5):610–9.

    Article  Google Scholar 

  34. Catanzaro A, Cloud GA. Safety, tolerance, and efficacy of posaconazole therapy in patients with nonmeningeal disseminated or chronic pulmonary coccidioidomycosis. Clin Infect Dis. 2007;45:562.

    Article  CAS  Google Scholar 

  35. Muñoz-Hernández B, Martínez-Rivera MA, Palma Cortés G, et al. Mycelial forms of Coccidioides spp. in the parasitic phase associated to pulmonary coccidioidomycosis with type 2 diabetes mellitus. Eur J Clin Microbiol Infect Dis. 2008;27:813.

    Article  Google Scholar 

  36. Blair JE, Coakley B, Santelli AC, et al. Serologic testing for symptomatic coccidioidomycosis in immunocompetent and immunosuppressed hosts. Mycopathologia. 2006;162(5):317–24.

    Article  Google Scholar 

  37. Durkin M, Connolly P, Kuberski T, et al. Diagnosis of coccidioidomycosis with use of the Coccidioides antigen enzyme immunoassay. Clin Infect Dis. 2008;47(8):e69–73.

    Article  Google Scholar 

  38. Vucicevic D, Blair JE, Binnicker MJ, et al. The utility of Coccidioides polymerase chain reaction testing in the clinical setting. Mycopathologia. 2010;170(5):345–51.

    Article  CAS  Google Scholar 

  39. Wack EE, Ampel NM, et al. The return of delayed-Type Hypersensitivity skin testing for coccidioidomycosis. Clin Infect Dis. 2015;61(5):787–91.

    Article  CAS  Google Scholar 

  40. Galgiani JN, Catanzaro A, Cloud GA, et al. Mycoses Study Group. Comparison of oral fluconazole and itraconazole for progressive, nonmeningeal coccidioidomycosis. A randomized, double-blind trial. Ann Intern Med. 2000;133(9):676–86.

    Article  CAS  Google Scholar 

  41. Gonzalez GM. In vitro activities of isavuconazole against opportunistic filamentous and dimorphic fungi. Med Mycol. 2009;47(1):71–6.

    Article  CAS  Google Scholar 

  42. Levy ER, McCarty JM, Shane AL, et al. Treatment of pediatric refractory coccidioidomycosis with combination voriconazole and caspofungin: a retrospective case series. Clin Infect Dis. 2013;56(11):1573–8.

    Article  CAS  Google Scholar 

  43. Kuberski TT, Servi RJ, Rubin PJ. Successful treatment of a critically ill patient with disseminated coccidioidomycosis, using adjunctive interferon-gamma. Clin Infect Dis. 2004;38(6):910–2.

    Article  Google Scholar 

  44. Vincent T, Galgiani JN, Huppert M, et al. The natural history of coccidioidal meningitis: VA-Armed Forces cooperative studies, 1955-1958. Clin Infect Dis. 1993;16(2):247–54.

    Article  CAS  Google Scholar 

  45. Goughenour KD, Rappleye CA. Antifungal therapeutics for dimorphic fungal pathogens. Virulence. 2017;8(2):211–21.

    Article  CAS  Google Scholar 

  46. Shubitz LF, Yu JJ, Hung CY, et al. Improved protection of mice against lethal respiratory infection with Coccidioides posadasii using two recombinant antigens expressed as a single protein. Vaccine. 2006;24(31–32):5904–11.

    Article  CAS  Google Scholar 

  47. Hartgen BJ, Hung CY, Ostroff GR, et al. Construction and evaluation of a novel recombinant T cell epitope-based vaccine against coccidioidomycosis. Infect Immun. 2012;81(11):3960–74.

    Article  Google Scholar 

  48. Delgado N, Xue J, Yu JJ, et al. A recombinant Beta-1,3- glucanosyltransferase homologue of Coccidioides posadasii protects mice against coccidioidomycosis. Infect Immun. 2003;71(6):3010–9.

    Article  CAS  Google Scholar 

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Echeverri, A.F. (2019). Coccidioidal Arthritis. In: Espinoza, L. (eds) Infections and the Rheumatic Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-23311-2_20

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