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Rising burden of severe pediatric coccidioidomycosis: a 25-year single-center study
Sanchi Malhotra1, Kristina Adachi1, Ishminder Kaur1
1Department of Pediatrics, Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles CA, United States.
Journal of the Pediatric Infectious Diseases Society
|March 12, 2026
Summary
Pediatric coccidioidomycosis cases are rising in California, with disseminated disease leading to longer hospital stays and complex treatments. Early recognition and multidisciplinary care are crucial for managing this serious fungal infection in children.
Area of Science:
- Infectious Diseases
- Pediatric Mycology
- Epidemiology
Background:
- California has seen a significant increase in pediatric coccidioidomycosis incidence.
- Disseminated coccidioidomycosis, though rare, causes severe illness in children.
- The expanding endemic area necessitates sharing clinical experiences.
Purpose of the Study:
- To analyze the clinical characteristics and outcomes of pediatric coccidioidomycosis at a regional referral center.
- To describe trends in primary and disseminated coccidioidomycosis over a 25-year period.
- To inform clinical management and highlight the need for specialized care.
Main Methods:
- Retrospective observational study of pediatric patients (0-17 years) diagnosed with coccidioidomycosis.
- Data collected from January 1, 2000, to June 30, 2025, at UCLA.
- Analysis of patient demographics, disease type, treatment, and outcomes.
Main Results:
- A significant increase in pediatric coccidioidomycosis cases was observed.
- Disseminated coccidioidomycosis cases rose sharply, particularly between 2023-2025.
- Patients with disseminated disease experienced longer hospitalizations, treatment durations, and higher rates of antifungal modification and surgical intervention.
Conclusions:
- Pediatric coccidioidomycosis presents increasing clinical severity and resource demands in endemic regions.
- Heightened clinical vigilance and early recognition of dissemination are essential.
- Multidisciplinary collaboration and evaluation of optimal treatment strategies are needed for pediatric cases.
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