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dc.contributor.authorShemuel, Joseph
dc.contributor.authorBays, Derek J
dc.contributor.authorThompson, George R
dc.contributor.authorReef, Susan
dc.contributor.authorSnyder, Linda
dc.contributor.authorFreifeld, Alana J
dc.contributor.authorHuppert, Milt
dc.contributor.authorSalkin, David
dc.contributor.authorWilson, Machelle D
dc.contributor.authorGalgiani, John N
dc.date.accessioned2022-11-28T18:40:40Z
dc.date.available2022-11-28T18:40:40Z
dc.date.issued2022
dc.identifier.citationShemuel, J., Bays, D. J., Thompson III, G. R., Reef, S., Snyder, L., Freifeld, A. J., ... & Galgiani, J. N. (2022). Natural history of pulmonary coccidioidomycosis: Further examination of the VA-Armed Forces Database. Medical Mycology, 60(10), myac054.en_US
dc.identifier.pmid36166843
dc.identifier.doi10.1093/mmy/myac054
dc.identifier.urihttp://hdl.handle.net/10150/666986
dc.description.abstractThere are still many limitations related to the understanding of the natural history of differing forms of coccidioidomycosis (CM), including characterizing the spectrum of pulmonary disease. The historical Veterans Administration-Armed Forces database, recorded primarily before the advent of antifungal therapy, presents an opportunity to characterize the natural history of pulmonary CM. We performed a retrospective cohort study of 342 armed forces service members who were diagnosed with pulmonary CM at VA facilities between 1955 to 1958, followed through 1966, who did not receive antifungal therapy. Patients were grouped by predominant pulmonary finding on chest radiographs. The all-cause mortality was low for all patients (4.6%). Cavities had a median size of 3-3.9 cm (IQR: 2-2.9–4-4.9 cm), with heterogeneous wall thickness and no fluid level, while nodules had a median size of 1-1.19 cm (Interquartile range [IQR] 1-1.9–2-2.9 cm) and sharp borders. The majority of cavities were chronic (85.6%), and just under half were found incidentally. Median complement fixation titers in both the nodular and cavitary groups were negative, with higher titers in the cavitary group overall. This retrospective cohort study of non-disseminated coccidioidomycosis, the largest to date, sheds light on the natural history, serologic markers, and radiologic characteristics of this understudied disease. These findings have implications for the evaluation and management of CM.en_US
dc.language.isoenen_US
dc.publisherOxford University Pressen_US
dc.rights© The Author(s) 2022. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology.en_US
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/en_US
dc.subjectPulmonary coccidioidomycosisen_US
dc.subjectcavitary coccidioidomycosisen_US
dc.subjectnodular coccidioidomycosisen_US
dc.titleNatural history of pulmonary coccidioidomycosis: Further examination of the VA-Armed Forces Databaseen_US
dc.typeArticleen_US
dc.identifier.eissn1460-2709
dc.contributor.departmentDepartment of Internal Medicine, Division of Pulmonary/Critical Care and Palliative Medicine, University of Arizona-Tucsonen_US
dc.contributor.departmentValley Fever Center for Excellence, University of Arizona College of Medicine-Tucsonen_US
dc.contributor.departmentDepartment of Internal Medicine, Division of Infectious Diseases, University of Arizona College of Medicine-Tucsonen_US
dc.identifier.journalMedical Mycologyen_US
dc.description.note12 month embargo; published: 27 September 2022en_US
dc.description.collectioninformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.en_US
dc.eprint.versionFinal accepted manuscripten_US
dc.source.journaltitleMedical mycology
dc.source.volume60
dc.source.issue10
dc.source.countryUnited States
dc.source.countryUnited States
dc.source.countryEngland


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