Journal
ARCHIVES OF INTERNAL MEDICINE
Volume 165, Issue 1, Pages 113-117Publisher
AMER MEDICAL ASSOC
DOI: 10.1001/archinte.165.1.113
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Background: An endemic fungal infection of the desert southwestern United States, coccidioidomycosis is generally a self-limited illness in healthy persons. Immunosuppressed persons who contract coccidoidomycosis, however, are at increased risk for disseminated infection. Methods: We conducted a retrospective review of patients with coccidioidomycosis and hematologic malignancy or bone marrow disease. Results: Fifty-five patients were identified. The most common underlying malignancies were non-Hodgkin lymphoma and chronic lymphocytic leukemia. Extra-thoracic (or disseminated) infection was observed in 12 patients (22%). Fifteen patients (27%) died with active coccichoidomycosis. Treatment of the hematologic disease with corticosteroids or antineoplastic chemotherapy increased the risk of death. Conclusion: To date, this is the largest case series of patients with hematologic malignancy and coccichoidomycosis. In persons with hematologic malignancy, coccidioidomycosis can be a severe illness with a high risk for disseminated infection and death.
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