Fatal septic shock due to disseminated coccidioidomycosis: a case series and review of the literature
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 se...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-023-08379-6 |
| _version_ | 1827910937339756544 |
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| author | Piotr Wisniewski Isaac McCool John C. Walsh Chelsea Ausman Jenifer Edmondson Alexandra Perry Evan C. Ewers Ryan C. Maves |
| author_facet | Piotr Wisniewski Isaac McCool John C. Walsh Chelsea Ausman Jenifer Edmondson Alexandra Perry Evan C. Ewers Ryan C. Maves |
| author_sort | Piotr Wisniewski |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-13T01:57:21Z |
| format | Article |
| id | doaj.art-58cfc846114345e180ab4b9443ee2558 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-13T01:57:21Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-58cfc846114345e180ab4b9443ee25582023-07-02T11:08:57ZengBMCBMC Infectious Diseases1471-23342023-06-012311610.1186/s12879-023-08379-6Fatal septic shock due to disseminated coccidioidomycosis: a case series and review of the literaturePiotr Wisniewski0Isaac McCool1John C. Walsh2Chelsea Ausman3Jenifer Edmondson4Alexandra Perry5Evan C. Ewers6Ryan C. Maves7Operational Infectious Diseases Directorate, Naval Health Research CenterUniformed Services University School of MedicineDepartment of Pathology, Naval Medical Center San DiegoUniformed Services University School of MedicineUniformed Services University School of MedicineDepartment of Pulmonary and Critical Care Medicine, Naval Medical Center San DiegoUniformed Services University School of MedicineUniformed Services University School of MedicineAbstract 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.https://doi.org/10.1186/s12879-023-08379-6CoccidioidomycosisCoccidioidesSepsisSeptic shock |
| spellingShingle | Piotr Wisniewski Isaac McCool John C. Walsh Chelsea Ausman Jenifer Edmondson Alexandra Perry Evan C. Ewers Ryan C. Maves Fatal septic shock due to disseminated coccidioidomycosis: a case series and review of the literature BMC Infectious Diseases Coccidioidomycosis Coccidioides Sepsis Septic shock |
| title | Fatal septic shock due to disseminated coccidioidomycosis: a case series and review of the literature |
| title_full | Fatal septic shock due to disseminated coccidioidomycosis: a case series and review of the literature |
| title_fullStr | Fatal septic shock due to disseminated coccidioidomycosis: a case series and review of the literature |
| title_full_unstemmed | Fatal septic shock due to disseminated coccidioidomycosis: a case series and review of the literature |
| title_short | Fatal septic shock due to disseminated coccidioidomycosis: a case series and review of the literature |
| title_sort | fatal septic shock due to disseminated coccidioidomycosis a case series and review of the literature |
| topic | Coccidioidomycosis Coccidioides Sepsis Septic shock |
| url | https://doi.org/10.1186/s12879-023-08379-6 |
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