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Septic shock in coccidioidomycosis

E L Arsura1, P L Bellinghausen, W B Kilgore

  • 1Department of Medicine, Kern Medical Center, Bakersfield, CA 93305, USA.

Critical Care Medicine
|January 15, 1998
PubMed
Summary
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Septic shock from Coccidioides immitis infection is a serious, underrecognized condition. Early diagnosis and treatment are crucial for improving patient outcomes in coccidioidomycosis.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Pulmonology

Background:

  • Coccidioides immitis infection can lead to severe complications, including septic shock.
  • Septic shock in coccidioidomycosis is an underrecognized and often fatal condition.
  • Traditional immunocompromising factors were absent in affected patients.

Purpose of the Study:

  • To describe clinical and laboratory findings in patients with Coccidioides immitis-induced septic shock.
  • To estimate the incidence of septic shock in coccidioidomycosis.
  • To identify early diagnostic clues for this syndrome.

Main Methods:

  • Retrospective, descriptive case series.
  • Analysis of eight patients with Coccidioides immitis septic shock at a public hospital.

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  • Diagnosis based on C. immitis identification and American College of Chest Physicians/Society of Critical Care Medicine criteria for septic shock.

    • Main Results:

    • All patients presented with pulmonary symptoms and developed acute respiratory distress syndrome.
    • Six of eight patients had positive serology for coccidioidomycosis.
    • Despite amphotericin B treatment, all patients died due to progressive disease or organ failure.

    Conclusions:

    • Septic shock due to Coccidioides immitis is ominous and underrecognized.
    • Hemodynamic parameters were similar to gram-negative septic shock.
    • Clinical indicators include prolonged illness and significant pulmonary involvement; improved recognition may enhance outcomes.