Does the presence of mediastinal adenopathy confer a risk for disseminated infection in immunocompetent persons with pulmonary coccidioidomycosis?

Anita P. Mayer, Michael F. Morris, Prasad M. Panse, Marcia G. Ko, Julia A. Files, Barbara Ruddy, Janis E. Blair

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Pulmonary coccidioidomycosis is caused by inhaling airborne arthroconidia of Coccidioides, a soil-dwelling fungus endemic to the desert southwestern United States. Although uncommon, disseminated coccidioidal infection can be associated with well-defined risk factors, such as cell-mediated immunodeficiency, certain racial heritages (e.g. African or Filipino), male sex, or pregnancy. Before widespread use of computed tomography (CT), the presence or persistence of mediastinal lymphadenopathy was postulated to be a risk factor for disseminated coccidioidal infection. To investigate the use of CT scanning to identify the presence of mediastinal lymphadenopathy in patients with pulmonary coccidioidomycosis, and to correlate such lymphadenopathy with disseminated coccidioidal infection, we performed a retrospective review of patients with pulmonary coccidioidomycosis who were evaluated by chest CT. Two radiologists independently interpreted 150 CT scans from patients with pulmonary coccidioidomycosis. Forty-nine patients met CT criteria for mediastinal lymphadenopathy, whereas 101 patients did not. Disseminated coccidioidal infection was observed in 5 (10%) of the 49 patients with mediastinal lymphadenopathy and in 6 of the 101 (6%; P=34) without such adenopathy. Among patients with coccidioidomycosis, patients with mediastinal lymphadenopathy, as assessed by CT, had a higher rate of disseminated infection, but the difference was not statistically significant.

Original languageEnglish (US)
Pages (from-to)145-149
Number of pages5
JournalMycoses
Volume56
Issue number2
DOIs
StatePublished - Mar 2013

Fingerprint

Coccidioidomycosis
Lung
Tomography
Infection
Southwestern United States
Coccidioides
Lymphadenopathy
Inhalation
Fungi
Thorax
Soil
Pregnancy

Keywords

  • Coccidioides
  • Coccidioidomycosis
  • Computed tomography
  • Fungal infections
  • Mediastinal lymphadenopathy

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases

Cite this

Does the presence of mediastinal adenopathy confer a risk for disseminated infection in immunocompetent persons with pulmonary coccidioidomycosis? / Mayer, Anita P.; Morris, Michael F.; Panse, Prasad M.; Ko, Marcia G.; Files, Julia A.; Ruddy, Barbara; Blair, Janis E.

In: Mycoses, Vol. 56, No. 2, 03.2013, p. 145-149.

Research output: Contribution to journalArticle

Mayer, Anita P. ; Morris, Michael F. ; Panse, Prasad M. ; Ko, Marcia G. ; Files, Julia A. ; Ruddy, Barbara ; Blair, Janis E. / Does the presence of mediastinal adenopathy confer a risk for disseminated infection in immunocompetent persons with pulmonary coccidioidomycosis?. In: Mycoses. 2013 ; Vol. 56, No. 2. pp. 145-149.
@article{3db8009b91994babb93571b824fef0f1,
title = "Does the presence of mediastinal adenopathy confer a risk for disseminated infection in immunocompetent persons with pulmonary coccidioidomycosis?",
abstract = "Pulmonary coccidioidomycosis is caused by inhaling airborne arthroconidia of Coccidioides, a soil-dwelling fungus endemic to the desert southwestern United States. Although uncommon, disseminated coccidioidal infection can be associated with well-defined risk factors, such as cell-mediated immunodeficiency, certain racial heritages (e.g. African or Filipino), male sex, or pregnancy. Before widespread use of computed tomography (CT), the presence or persistence of mediastinal lymphadenopathy was postulated to be a risk factor for disseminated coccidioidal infection. To investigate the use of CT scanning to identify the presence of mediastinal lymphadenopathy in patients with pulmonary coccidioidomycosis, and to correlate such lymphadenopathy with disseminated coccidioidal infection, we performed a retrospective review of patients with pulmonary coccidioidomycosis who were evaluated by chest CT. Two radiologists independently interpreted 150 CT scans from patients with pulmonary coccidioidomycosis. Forty-nine patients met CT criteria for mediastinal lymphadenopathy, whereas 101 patients did not. Disseminated coccidioidal infection was observed in 5 (10{\%}) of the 49 patients with mediastinal lymphadenopathy and in 6 of the 101 (6{\%}; P=34) without such adenopathy. Among patients with coccidioidomycosis, patients with mediastinal lymphadenopathy, as assessed by CT, had a higher rate of disseminated infection, but the difference was not statistically significant.",
keywords = "Coccidioides, Coccidioidomycosis, Computed tomography, Fungal infections, Mediastinal lymphadenopathy",
author = "Mayer, {Anita P.} and Morris, {Michael F.} and Panse, {Prasad M.} and Ko, {Marcia G.} and Files, {Julia A.} and Barbara Ruddy and Blair, {Janis E.}",
year = "2013",
month = "3",
doi = "10.1111/j.1439-0507.2012.02224.x",
language = "English (US)",
volume = "56",
pages = "145--149",
journal = "Mycoses",
issn = "0933-7407",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Does the presence of mediastinal adenopathy confer a risk for disseminated infection in immunocompetent persons with pulmonary coccidioidomycosis?

AU - Mayer, Anita P.

AU - Morris, Michael F.

AU - Panse, Prasad M.

AU - Ko, Marcia G.

AU - Files, Julia A.

AU - Ruddy, Barbara

AU - Blair, Janis E.

PY - 2013/3

Y1 - 2013/3

N2 - Pulmonary coccidioidomycosis is caused by inhaling airborne arthroconidia of Coccidioides, a soil-dwelling fungus endemic to the desert southwestern United States. Although uncommon, disseminated coccidioidal infection can be associated with well-defined risk factors, such as cell-mediated immunodeficiency, certain racial heritages (e.g. African or Filipino), male sex, or pregnancy. Before widespread use of computed tomography (CT), the presence or persistence of mediastinal lymphadenopathy was postulated to be a risk factor for disseminated coccidioidal infection. To investigate the use of CT scanning to identify the presence of mediastinal lymphadenopathy in patients with pulmonary coccidioidomycosis, and to correlate such lymphadenopathy with disseminated coccidioidal infection, we performed a retrospective review of patients with pulmonary coccidioidomycosis who were evaluated by chest CT. Two radiologists independently interpreted 150 CT scans from patients with pulmonary coccidioidomycosis. Forty-nine patients met CT criteria for mediastinal lymphadenopathy, whereas 101 patients did not. Disseminated coccidioidal infection was observed in 5 (10%) of the 49 patients with mediastinal lymphadenopathy and in 6 of the 101 (6%; P=34) without such adenopathy. Among patients with coccidioidomycosis, patients with mediastinal lymphadenopathy, as assessed by CT, had a higher rate of disseminated infection, but the difference was not statistically significant.

AB - Pulmonary coccidioidomycosis is caused by inhaling airborne arthroconidia of Coccidioides, a soil-dwelling fungus endemic to the desert southwestern United States. Although uncommon, disseminated coccidioidal infection can be associated with well-defined risk factors, such as cell-mediated immunodeficiency, certain racial heritages (e.g. African or Filipino), male sex, or pregnancy. Before widespread use of computed tomography (CT), the presence or persistence of mediastinal lymphadenopathy was postulated to be a risk factor for disseminated coccidioidal infection. To investigate the use of CT scanning to identify the presence of mediastinal lymphadenopathy in patients with pulmonary coccidioidomycosis, and to correlate such lymphadenopathy with disseminated coccidioidal infection, we performed a retrospective review of patients with pulmonary coccidioidomycosis who were evaluated by chest CT. Two radiologists independently interpreted 150 CT scans from patients with pulmonary coccidioidomycosis. Forty-nine patients met CT criteria for mediastinal lymphadenopathy, whereas 101 patients did not. Disseminated coccidioidal infection was observed in 5 (10%) of the 49 patients with mediastinal lymphadenopathy and in 6 of the 101 (6%; P=34) without such adenopathy. Among patients with coccidioidomycosis, patients with mediastinal lymphadenopathy, as assessed by CT, had a higher rate of disseminated infection, but the difference was not statistically significant.

KW - Coccidioides

KW - Coccidioidomycosis

KW - Computed tomography

KW - Fungal infections

KW - Mediastinal lymphadenopathy

UR - http://www.scopus.com/inward/record.url?scp=84874321131&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84874321131&partnerID=8YFLogxK

U2 - 10.1111/j.1439-0507.2012.02224.x

DO - 10.1111/j.1439-0507.2012.02224.x

M3 - Article

C2 - 22809175

AN - SCOPUS:84874321131

VL - 56

SP - 145

EP - 149

JO - Mycoses

JF - Mycoses

SN - 0933-7407

IS - 2

ER -