Coccidioidomycosis in patients with hematologic malignancies

Area of Science:

• Mycology
• Infectious Diseases
• Hematology

Background:

• Coccidioidomycosis is an endemic fungal infection in the southwestern United States.
• While typically self-limited in healthy individuals, it carries a higher risk of dissemination in immunocompromised patients.

Purpose of the Study:

• To investigate the clinical outcomes of coccidioidomycosis in patients with hematologic malignancy.
• To identify risk factors associated with severe disease and mortality in this patient group.

Main Methods:

• A retrospective review was conducted on patients diagnosed with coccidioidomycosis and co-existing hematologic malignancy or bone marrow disease.
• Patient data were analyzed to determine the incidence of disseminated infection, common underlying malignancies, and mortality rates.

Main Results:

• Fifty-five patients with hematologic malignancy and coccidioidomycosis were identified.
• Non-Hodgkin lymphoma and chronic lymphocytic leukemia were the most frequent underlying malignancies.
• Disseminated infection occurred in 22% of patients, and 27% died with active coccidioidomycosis. Treatment with corticosteroids or chemotherapy increased mortality risk.

Conclusions:

• This case series represents the largest to date for patients with hematologic malignancy and coccidioidomycosis.
• Coccidioidomycosis is a severe illness in patients with hematologic malignancy, associated with significant risks of disseminated infection and death.
• Hematologic malignancy status is a critical factor influencing the severity and prognosis of coccidioidomycosis.