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Review
. 2013 Jul;26(3):505-25.
doi: 10.1128/CMR.00005-13.

Recent advances in our understanding of the environmental, epidemiological, immunological, and clinical dimensions of coccidioidomycosis

Chinh Nguyen  1 , Bridget Marie Barker, Susan Hoover, David E Nix, Neil M Ampel, Jeffrey A Frelinger, Marc J Orbach, John N Galgiani
Affiliations
Review

Recent advances in our understanding of the environmental, epidemiological, immunological, and clinical dimensions of coccidioidomycosis

Chinh Nguyen et al. Clin Microbiol Rev. 2013 Jul.

Abstract

Coccidioidomycosis is the endemic mycosis caused by the fungal pathogens Coccidioides immitis and C. posadasii. This review is a summary of the recent advances that have been made in the understanding of this pathogen, including its mycology, genetics, and niche in the environment. Updates on the epidemiology of the organism emphasize that it is a continuing, significant problem in areas of endemicity. For a variety of reasons, the number of reported coccidioidal infections has increased dramatically over the past decade. While continual improvements in the fields of organ transplantation and management of autoimmune disorders and patients with HIV have led to dilemmas with concurrent infection with coccidioidomycosis, they have also led to advances in the understanding of the human immune response to infection. There have been some advances in therapeutics with the increased use of newer azoles. Lastly, there is an overview of the ongoing search for a preventative vaccine.

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Figures

Fig 1
Fig 1
Life cycle of Coccidioides spp. Both C. immitis and C. posadasii share the same asexual life cycle, which is represented here. The parasitic phase occurs in the host. The saprotrophic life cycle occurs in the soil environment.
Fig 2
Fig 2
New cases of coccidioidomycosis reported to the Arizona and California Departments of Public Health. Provisional 2012 statistics for Arizona were supplied by C. Tsang, Arizona Department of Health Services (personal communication), and those for California are from reference . (Adapted from reference .)
Fig 3
Fig 3
The July 2011 dust storms in Maricopa County, AZ, were so severe that they garnered national attention. (Courtesy of Mike Olbinsky.)
Fig 4
Fig 4
Dermal hypersensitivity mapping of the endemic intensity of coccidioidomycosis. (Adapted from reference [edited by Libero Ajello] with permission of the University of Arizona Press. © 1967 The Arizona Board of Regents.)
Fig 5
Fig 5
Map of case rates of coccidioidomycosis by county in Arizona in 2006 and in California from 2001 to 2009.
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See this image and copyright information in PMC

References

    1. Galgiani JN. 2007. Coccidioidomycosis: changing perceptions and creating opportunities for its control. Ann. N. Y. Acad. Sci. 1111: 1–18 - PubMed
    1. Hirschmann JV. 2007. The early history of coccidioidomycosis: 1892–1945. Clin. Infect. Dis. 44: 1202–1207 - PubMed
    1. Barker BM. 2009. Population genetics and genomics of Coccidioides immitis and Coccidioides posadasii. University of Arizona, Tucson, AZ
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    1. Cox RA, Magee DM. 2004. Coccidioidomycosis: host response and vaccine development. Clin. Microbiol. Rev. 17: 804–839 - PMC - PubMed

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