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[Coccidioidomycosis in children].

T Carrada-Bravo

Boletin Medico Del Hospital Infantil De Mexico

|July 1, 1989

Summary

Coccidioidomycosis, caused by the fungus Coccidioides immitis, is prevalent in arid regions. Infection occurs via airborne arthroconidia, with serologic tests aiding diagnosis and antifungal medications or surgery for severe cases.

Area of Science:

Mycology
Infectious Diseases
Public Health

Background:

Coccidioides immitis causes coccidioidomycosis, endemic in the Southwestern US, Mexico, and parts of Central/South America.
Favorable conditions for arthroconidia include hot summers, minimal frost, and arid, alkaline soils.
Infection routes involve inhaling dustborne arthroconidia or direct soil contact.

Purpose of the Study:

To provide a comprehensive overview of coccidioidomycosis, including its etiology, epidemiology, clinical manifestations, diagnosis, and treatment.
To highlight the environmental factors contributing to the fungus's prevalence.
To discuss the varied clinical presentations and diagnostic approaches.

Main Methods:

Literature review of coccidioidomycosis epidemiology, clinical features, and treatment modalities.

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Analysis of diagnostic methods including serologic tests (precipitins, complement fixation) and skin testing.

Summary of therapeutic interventions, including antifungal drugs and surgical options.

Main Results:

Primary pulmonary infection is often asymptomatic or flu-like; disseminated disease can mimic tuberculosis.
Erythema multiforme, erythema nodosum, and arthralgias are noted clinical signs.
Serologic tests are crucial for diagnosis, with elevated titers indicating severe or disseminated infection.
Mexican children show a higher predilection for meningitis and localized dissemination compared to adults.

Conclusions:

Coccidioidomycosis diagnosis relies on clinical suspicion supported by serologic and skin test conversions.
While many cases resolve without treatment, severe or disseminated forms require amphotericin B or ketoconazole.
Surgery may be necessary for localized, persistent, or drug-resistant lesions.