Volume 23, Number 2—February 2017
CME ACTIVITY - Dispatch
Risk Factors for Disseminated Coccidioidomycosis, United States
Camila D. Odio1, Beatriz E. Marciano, John N. Galgiani, and Steven M. Holland
Table 2
Patients with disseminated coccidioidomycosis and discrete primary immune deficiencies*
| Patient no. (ref) |
Age, y/sex |
Race/
ethnicity |
Medical history |
Extrapulmonary disease |
Relapse |
Method of diagnosis |
Genetic findings |
| 1 |
4/F |
White |
HIES, recurrent pneumonia and otitis, skin infections, eczema, thrush |
Meningitis |
No |
BAL/CSF cultures |
STAT3: heterozygous (c.2137G>A) |
| 2 (9) |
17/F |
Not reported |
HIES, Staphylococcus. aureus skin and soft tissue infections, recurrent sinus infections, pneumonia |
Meningitis, cerebral abscess |
No |
Coccidioides Ab, CSF culture |
STAT3: heterozygous (p.T412S) |
| 3 (10) |
11/M |
White |
11 mo: Mycobacterium chelonei pneumonia 22 y; disseminated M. kansasii |
Osteomyelits, lymphadenitis |
Yes |
Coccidioides Ab level, lymph node biopsy |
IFN-γR1: deficiency (c.818del4fs) |
| 4 (11)† |
22/F |
Palestinian |
11 y: Salmonella serogroup D lymphadenitis |
Diffuse lymphadenitis |
Yes |
Coccidioides IgM and IgG, lymph node biopsy |
IL-12Rβ1: homozygous (p.C186Y) |
| 5 (11) |
6/M |
Palestinian |
No other significant history |
Osteomyelitis, lymphadenitis, nasal lesion, |
Yes |
Lymph node, nasal lesion, bone biopsies |
IL-12Rβ1: homozygous (p.C186Y) |
| 6 |
15/M |
Black |
No other significant history |
Osteomyelitis, soft tissue |
Yes |
BAL cultures, bone and soft biopsies |
IL-12Rβ2: heterozygous (p.C101Y) |
| 7 (12) |
17/F |
Hispanic |
14 y: extensive, persistent tinea capitis and kerion caused by Trichophyton tonsurans |
Osteomyelitis, soft tissue, cutaneous lesions |
Yes |
Coccidioides Ab, skin biopsy |
STAT1: gain of function mutation
(p.E353K) |
| 8 (12) | 9.5/F | White | No other significant history | Osteomyelitis, cerebral lesions, intrathoracic lymphadenitis | Yes | Coccidioides Ab | STAT1: gain of function mutation (p.A267V) |
*Ab, antibody; BAL, bronchoalveolar lavage; CSF, cerebrospinal fluid; HIES, hyperimmunoglobulin E (Job’s) syndrome; ref, reference.
†Patients 4 and 5 are siblings, and their parents are first cousins.
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1Current affiliation: Yale–New Haven Hospital, New Haven, Connecticut, USA.
Page created: January 12, 2017
Page updated: January 12, 2017
Page reviewed: January 12, 2017
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