Rapidity of Coccidioidomycosis Diagnosis and Its Effect on Healthcare Utilization.

Abstract

Background: Coccidioidomycosis is an infection caused by the fungal Coccidioides species common to Central and South America, and the southwestern United States, with Arizona claiming the vast majority of U.S.-based cases. Recognizing and diagnosing coccidioidomycosis is often difficult, with the wide range of symptoms being commonly misdiagnosed as a bacterial community-acquired pneumonia. Misdiagnosis and a delay in true diagnosis leads to ineffective, costly, and burdensome ramifications. Data investigating the diagnostic delay of Coccidioidomycosis could provide means for future changes in clinical practice. Methods: This is a two-phase study: phase one assessed disease markers and symptomatology, and phase two analyzing healthcare utilization based on electronic medical record data extraction of 139 patients. Results: The mean and median for 0-30 days of delay was $6,273 and $770 respectively; this increased at 151-183 days of diagnostic delay to $57,724 and $8,917 respectively. Small final population size precluded meaningful statistical analysis. Conclusion: Demonstrating diagnostic delay characteristics for patients with coccidioidomycosis is possible, however due to small final population size and difficulties encountered due to the innate properties of the electronic medical record, future investigation and optimization will be necessary for more powerful analysis.