Coccidioidal Tenosynovitis of the Hand and Wrist: Report of 9 Cases and Review of the Literature

Mark Campbell, Shimon Kusne, Kevin J. Renfree, Holenarasipur R. Vikram, Jerry D. Smilack, Maria T. Seville, Robert Orenstein, Janis E. Blair

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background.Tenosynovitis is an uncommon manifestation of disseminated infection with Coccidioides fungal species. Most experts treat this infection with combined surgical debridement and antifungal medication. The aim of our study was to examine the outcomes of patients with coccidioidal tenosynovitis of the hand and wrist. Methods.We retrospectively searched for the records of patients with coccidioidal tenosynovitis of the hand and wrist at our institution. between 1987 and 2013. We also conducted a review of the literature from 1950 to 2014 to identify additional cases. Results.We identified 9 cases of coccidioidal tenosynovitis of the hand and wrist at our institution, along with 5 other cases found in a review of the literature. The relapse rate was high overall (50%) and was higher after discontinuation of antifungal therapy (71%) in both immunocompromised and immunocompetent patients. Results of serologic testing were not predictive of relapse. Conclusions.A treatment strategy for coccidioidal tenosynovitis should focus on long-term administration of antifungal agents.

Original languageEnglish (US)
Pages (from-to)1514-1520
Number of pages7
JournalClinical Infectious Diseases
Volume61
Issue number10
DOIs
StatePublished - Nov 15 2015

Keywords

  • Coccidioides species
  • coccidioidal tenosynovitis
  • coccidioidomycosis
  • fungal infection
  • hand and wrist

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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