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. 2013 Jun 25:5:185-97.
doi: 10.2147/CLEP.S34434. Print 2013.

Coccidioidomycosis: epidemiology

Affiliations

Coccidioidomycosis: epidemiology

Jennifer Brown et al. Clin Epidemiol. .

Abstract

Coccidioidomycosis consists of a spectrum of disease, ranging from a mild, self-limited, febrile illness to severe, life-threatening infection. It is caused by the soil-dwelling fungi, Coccidioides immitis and C. posadasii, which are present in diverse endemic areas. Climate changes and environmental factors affect the Coccidioides lifecycle and influence infection rates. The incidence of coccidioidomycosis has risen substantially over the past two decades. The vast majority of Coccidioides infections occur in the endemic zones, such as California, Arizona, Mexico, and Central America. Infections occurring outside those zones appear to be increasingly common, and pose unique clinical and public health challenges. It has long been known that elderly persons, pregnant women, and members of certain ethnic groups are at risk for severe or disseminated coccidioidomycosis. In recent years, it has become evident that persons with immunodeficiency diseases, diabetics, transplant recipients, and prisoners are also particularly vulnerable.

Keywords: Coccidioides; coccidioidomycosis; epidemiology; geography; incidence; risk factors.

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Figures

Figure 1
Figure 1
Life cycle of Coccidioides spp. Notes: In the environment Coccidioides exists as a mycelium and following periods of low precipitation arthroconidia are formed and are easily aerosolized when disturbed. Arthroconidia can be inhaled or return to the soil and again grow to vegetative mycelia. However if inhaled, arthroconidia undergo a morphologic change and become immature spherules which divide internally until filled with endospores and subsequently rupture. Endospores are dispersed into the surrounding tissue and are then able to form new spherules and repeat the cycle.
Figure 2
Figure 2
Endemic areas for coccidioidomycosis.
Figure 3
Figure 3
Incidence of coccidioidomycosis in Arizona and California, 1998–2011.

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