ABSTRACT

Coccidioidomycosis has affected people who live in the Southwestern desert of the United States for several years. However, in the last years the number of cases has increased dramatically. In this article, we present an extensive review of the disease and a series of cases in the INCMNSZ. We identified 7 cases of coccidioidomycosis in the Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán” (INCMNSZ) (4 men and 3 women, ages from 19 to 65 years old) from 1983 to 2006, within a retrospective and comparative study. Two cases lived in an endemic zone for coccidioidomycosis. Five of the 7 patients were immunocompetent. Those considered inmunosupresed one had positive western Blot asay for VIH, and the other one had DM2 and chronic liver disease because of VHC infection. The initial clinical features were cough and/or fever in all of the patients. Four of the patients had pulmonary disease, the other 3 patients had disseminated coccidioidomycosis none was inmunocompromised. The outcome in most of the cases was adverse even though the therapy of choice was given in each case. We registered 3 deaths, 1 of the patients was on bad clinical status at discharge and his final outcome is unknown (discharge requested by the family). One case did not come for follow up (although was on good clinical status at discharge) and only 2 of the patients presented excellent response to treatment although they had disseminated disease and both of them had relapsing disease. Contrary to the statistics, in the INCMNSZ there has been more patients with coccidioidomycosis who are immunocompetent (5) than the immunocompromised (2).

KEYWORDS

Coccidioidomycosis, pulmonary coccidioidomycosis, disseminated coccidioidomycosis, immunocompetent, immunocompromised.

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