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- Title
Fatal septic shock due to disseminated coccidioidomycosis: a case series and review of the literature.
- Authors
Wisniewski, Piotr; McCool, Isaac; Walsh, John C.; Ausman, Chelsea; Edmondson, Jenifer; Perry, Alexandra; Ewers, Evan C.; Maves, Ryan C.
- Abstract
Background: Coccidioidomycosis is a fungal infection endemic to the southwestern United States and regions of Latin America. Disseminated disease occurs in < 1% of cases. Septic shock is even rarer, with high mortality despite therapy. Case summary: We describe two cases of coccidioidal septic shock. Both patients were older men of Filipino ancestry presenting with respiratory failure and vasopressor-dependent shock. Antifungal drugs were initiated after failure to improve with empiric antibiotics; in both, Coccidioides was isolated from respiratory cultures. Despite aggressive care, both patients ultimately died of their infections. We provide a review of the published literature on this topic. Conclusions: Most of the 33 reported cases of coccidioidal septic shock occurred in men (88%) of non-white race and ethnicity (78%). The overall mortality rate was 76%. All survivors received amphotericin B as part of their treatment. Coccidioidomycosis-related septic shock is a rare disease with poor outcomes; delays in diagnosis and treatment are common. Improved diagnostic testing for coccidioidomycosis could enhance recognition of this disease in the future. Although data are limited, early treatment with amphotericin B in cases of coccidioidal septic shock may reduce mortality.
- Subjects
UNITED States; SEPTIC shock; LITERATURE reviews; ENDEMIC diseases; MYCOSES; AMPHOTERICIN B
- Publication
BMC Infectious Diseases, 2023, Vol 23, Issue 1, p1
- ISSN
1471-2334
- Publication type
Article
- DOI
10.1186/s12879-023-08379-6