Coccidioidomycosis During Pregnancy: A Review and Recommendations for Management

University of California, San Diego, California, USA.
Clinical Infectious Diseases (Impact Factor: 8.89). 08/2011; 53(4):363-8. DOI: 10.1093/cid/cir410
Source: PubMed


Pregnancy is an established risk factor for the development of severe and disseminated coccidioidomycosis, particularly when
infection is acquired during the later stages of gestation. Although recent studies suggest that the incidence of symptomatic
coccidioidomycosis during pregnancy is decreasing and that outcome has improved, management is complicated by the observations
that azole antifungal agents can be teratogenic when given to some women, particularly at high doses, early in pregnancy.
This article summarizes the data on these issues and offers guidance on the management of coccidioidomycosis during pregnancy.

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    • "Abortion due to Coccidioides infection has been reported in two mares [6] [12] and there is only sporadic anecdotal evidence of occurrence in other domestic animals. While pregnancy is considered to be a risk factor for severe disseminated coccidioidomycosis of the mother in humans, fetal or neonatal coccidioidomycosis is uncommon [1] [3] [5]. Reports of human neonatal coccidioidomycosis have suggested that aspiration of infected vaginal secretions during the birth may be the mode of transmission [13] [14]. "
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    ABSTRACT: Coccidioidomycosis is a fungal disease affecting humans and other mammals caused by the soil-dwelling fungi Coccidioides immitis and C. posadasii. Abortion due to Coccidioides spp. infection is rare in domestic animals and transplacental transmission is considered uncommon in women. This report describes a case of placental-fetal infection and abortion in an alpaca with disseminated C. posadasii infection. PCR amplification and DNA sequencing were used to confirm the etiology, C. posadasii, in fetal tissues.
    Full-text · Article · Dec 2013 · Medical Mycology Case Reports
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    • "Pregnant women are especially vulnerable to coccidioidal infection, and their risk of developing severe or disseminated disease rises when infection is acquired in the later stages of pregnancy.74,75 Also, severe coccidioidomycosis is more likely to occur during the immediate postpartum period if infection is acquired in the third trimester.74,76 "
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    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.
    Preview · Article · Jun 2013 · Clinical Epidemiology
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    ABSTRACT: Coccidioides immitis and C. posadasii are pathogenic dimorphic fungi responsible for causing coccidioidomycosis in the southwestern part of United States. Incidence of this disease continues to rise in endemic areas. Coccidioidomycosis starts as a respiratory illness and in less than 5 % of cases disseminates to other anatomic sites. Patient management requires careful periodic assessment. Some patients require no therapy, while others require antifungal medications for several months, or in some cases, indefinitely. Factors that influence the decision to treat include degree and duration of patient symptoms, radiographic findings, anti-complementary titers, immunosuppression and comorbidites. Cure for disseminated infection appears to be an unreachable goal with current treatments.
    No preview · Article · Mar 2012 · Current Fungal Infection Reports
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