State-of-the-art treatment of coccidioidomycosis skeletal infections

Janis E. Blair

Research output: Chapter in Book/Report/Conference proceedingConference contribution

23 Citations (Scopus)

Abstract

Coccidioidomycosis is a fungal infection endemic to the southwestern United States. Typically a respiratory illness, coccidioidomycosis can rarely present as extrapulmonary infection. Skeletal coccidioidomycosis occurs in 20% to 50% of disseminated infections. Skeletal coccidioidomycosis is a chronic and progressive infection that eventually results in bone destruction and loss of function and often involves adjacent structures, such as joints, muscles, and tendons and other soft tissues. Sinus tract formation may occur. This infection may be multifocal. Although radiographs, white blood cell count scans, and other imaging methods identify and define relevant abnormalities, histopathologic examination with culture of the involved bone is the only means to confirm the diagnosis. Serologic testing is adjunctive, and complement fixation titers can be evaluated serially to assess response to treatment. A number of studies addressing the efficacy of various antifungal agents have been performed, and the results of these studies as they pertain to skeletal coccidioidomycosis are summarized herein. Among the various studies, response rates ranged from 23% to 100%, but relapse was common. A combination of medical therapy - often, itraconazole or fluconazole - and surgical d'ebridement is often needed to control skeletal coccidioidomycosis. Early diagnosis and treatment are critical to avoid long-term problems with chronically infected bones and joints. Anatomical issues, diagnostic studies, and data related to treatment of this form of extrapulmonary coccidioidomycosis are reviewed in this article.

Original languageEnglish (US)
Title of host publicationAnnals of the New York Academy of Sciences
Pages422-433
Number of pages12
Volume1111
DOIs
StatePublished - Sep 2007

Publication series

NameAnnals of the New York Academy of Sciences
Volume1111
ISSN (Print)00778923
ISSN (Electronic)17496632

Fingerprint

Coccidioidomycosis
Bone
Infection
Itraconazole
Fluconazole
Antifungal Agents
Tendons
Muscle
Bone and Bones
Blood
Cells
Tissue
Joints
Imaging techniques
Southwestern United States
Testing
Mycoses
Leukocyte Count
Early Diagnosis
Recurrence

Keywords

  • Coccidioides
  • Coccidioidomycosis
  • Fungal skeletal diseases

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Blair, J. E. (2007). State-of-the-art treatment of coccidioidomycosis skeletal infections. In Annals of the New York Academy of Sciences (Vol. 1111, pp. 422-433). (Annals of the New York Academy of Sciences; Vol. 1111). https://doi.org/10.1196/annals.1406.000

State-of-the-art treatment of coccidioidomycosis skeletal infections. / Blair, Janis E.

Annals of the New York Academy of Sciences. Vol. 1111 2007. p. 422-433 (Annals of the New York Academy of Sciences; Vol. 1111).

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Blair, JE 2007, State-of-the-art treatment of coccidioidomycosis skeletal infections. in Annals of the New York Academy of Sciences. vol. 1111, Annals of the New York Academy of Sciences, vol. 1111, pp. 422-433. https://doi.org/10.1196/annals.1406.000
Blair JE. State-of-the-art treatment of coccidioidomycosis skeletal infections. In Annals of the New York Academy of Sciences. Vol. 1111. 2007. p. 422-433. (Annals of the New York Academy of Sciences). https://doi.org/10.1196/annals.1406.000
Blair, Janis E. / State-of-the-art treatment of coccidioidomycosis skeletal infections. Annals of the New York Academy of Sciences. Vol. 1111 2007. pp. 422-433 (Annals of the New York Academy of Sciences).
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