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Frequency, Interval, and Patient Factors Associated With Recurrence of Disseminated Cutaneous Coccidioidomycosis

Summary

This study looked at how often a serious fungal skin infection called coccidioidomycosis comes back after treatment. Researchers found that about 25% of patients experienced at least one recurrence after stopping antifungal medications, with the average time before it returned being 14 months. Some patients had multiple recurrences, and most of the time the infection returned to the same location on the body.

Background

Coccidioidomycosis is a fungal infection caused by Coccidioides and a common cause of community-acquired pneumonia in endemic regions. Disseminated cutaneous coccidioidomycosis (DCC) occurs in 15-67% of disseminated cases, though limited data exists describing the frequency and timing of recurrence.

Objective

To determine the frequency, timeframe, and risk factors for relapsed disseminated cutaneous coccidioidomycosis in a retrospective cohort study.

Results

Of 47 DCC cases (33 males, 14 females, median age 48 years), 12 (25.5%) had ≥1 recurrence with median interval off antifungals of 14 months. 3 (6.4%) had recurrence within three months, 6 (13.0%) by year 1, and 11 (23.9%) by year 5. 87.5% of recurrences occurred at the same site, and immunosuppressed patients had lower recurrence rates when continuing antifungal therapy.

Conclusion

Recurrence of disseminated cutaneous coccidioidomycosis was common after discontinuation of antifungal treatment, with multiple relapses noted in some patients. Longer follow-up is needed to better characterize long-term recurrence risk.
  • Published in:Open Forum Infectious Diseases,
  • Study Type:Retrospective Cohort Study,
  • Source: 10.1093/ofid/ofae631.2283, PMC11777605
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