Tissue eosinophilia in human coccidioidomycosis

Area of Science:

• Medical Mycology
• Immunology
• Pathology

Background:

• Coccidioidomycosis is a fungal infection caused by Coccidioides immitis.
• Eosinophilia, elevated eosinophil counts, is a known host response to fungal infections.
• The prognostic significance of eosinophilia in coccidioidomycosis requires further clarification.

Purpose of the Study:

• To investigate the role and prognostic value of eosinophilia in patients with coccidioidomycosis.
• To correlate peripheral blood and tissue eosinophil levels with disease severity and progression.

Main Methods:

• Review of peripheral blood and tissue eosinophil counts in patients with coccidioidomycosis.
• Correlation of eosinophilia with clinical presentation (primary, disseminated, progressive disease).
• Histopathological examination of tissue for eosinophils and microabscess formation.

Main Results:

• Peripheral blood eosinophilia (>5%) observed in primary infection; higher levels (27%-53%) in disseminated cases.
• Tissue eosinophils and eosinophilic microabscesses found in patients with progressive/disseminated disease.
• High peripheral blood eosinophilia (>20%) and eosinophilic microabscesses correlated with poor prognosis.

Conclusions:

• Eosinophilia in coccidioidomycosis is not always a favorable sign.
• Significant peripheral blood eosinophilia and tissue eosinophilic microabscesses indicate severe, disseminated Coccidioides immitis infection.
• These findings suggest a poor prognosis in affected patients.