TY - GEN
T1 - Coccidioidomycosis in rheumatology patients
T2 - Incidence and potential risk factors
AU - Mertz, Lester E.
AU - Blair, Janis E.
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2007/9
Y1 - 2007/9
N2 - Coccidioidomycosis is a potentially serious fungal infection contracted in endemic areas of the desert southwestern United States. Limited information exists about its incidence and clinical course in patients with rheumatic diseases, who may be at higher risk of symptomatic or disseminated coccidioidomycosis because of either the rheumatic disease itself or its treatment. We analyzed the incidence and risk factors for symptomatic and complicated coccidioidomycosis in our academic rheumatology practice in central Arizona. Between January 1, 2000, and June 30, 2006, coccidioidomycosis was diagnosed in 1.9% of the overall practice and in 3.1-3.6% of patients with rheumatoid arthritis (RA). The annual incidence was 1%in patients recently diagnosed with RA and 2% among patients with recently initiated infliximab treatment. Coccidioidomycosis was identified only in patients with inflammatory rheumatic diseases and extrathoracic dissemination occurred only to joints in two patients. Corticosteroids, immunosuppressive medications, and tumor necrosis factor inhibitors (TNFIs) appeared to be risk factors for symptomatic, but not disseminated coccidioidomycosis.
AB - Coccidioidomycosis is a potentially serious fungal infection contracted in endemic areas of the desert southwestern United States. Limited information exists about its incidence and clinical course in patients with rheumatic diseases, who may be at higher risk of symptomatic or disseminated coccidioidomycosis because of either the rheumatic disease itself or its treatment. We analyzed the incidence and risk factors for symptomatic and complicated coccidioidomycosis in our academic rheumatology practice in central Arizona. Between January 1, 2000, and June 30, 2006, coccidioidomycosis was diagnosed in 1.9% of the overall practice and in 3.1-3.6% of patients with rheumatoid arthritis (RA). The annual incidence was 1%in patients recently diagnosed with RA and 2% among patients with recently initiated infliximab treatment. Coccidioidomycosis was identified only in patients with inflammatory rheumatic diseases and extrathoracic dissemination occurred only to joints in two patients. Corticosteroids, immunosuppressive medications, and tumor necrosis factor inhibitors (TNFIs) appeared to be risk factors for symptomatic, but not disseminated coccidioidomycosis.
KW - Coccidioidomycosis
KW - Corticosteroids
KW - Disease-modifying antirheumatic drug
KW - Immunosuppression
KW - Incidence
KW - Rheumatoid arthritis
KW - Tumor necrosis factor inhibitors
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U2 - 10.1196/annals.1406.027
DO - 10.1196/annals.1406.027
M3 - Conference contribution
C2 - 17363440
AN - SCOPUS:35348900733
SN - 1573316881
SN - 9781573316880
T3 - Annals of the New York Academy of Sciences
SP - 343
EP - 357
BT - Coccidioidomycosis Sixth International Symposium
PB - Blackwell Publishing Inc.
ER -