Coccidioidomycosis in rheumatology patients: Incidence and potential risk factors

Lester E. Mertz, Janis E. Blair

Research output: Chapter in Book/Report/Conference proceedingConference contribution

36 Scopus citations


Coccidioidomycosis is a potentially serious fungal infection contracted in endemic areas of the desert southwestern United States. Limited information exists about its incidence and clinical course in patients with rheumatic diseases, who may be at higher risk of symptomatic or disseminated coccidioidomycosis because of either the rheumatic disease itself or its treatment. We analyzed the incidence and risk factors for symptomatic and complicated coccidioidomycosis in our academic rheumatology practice in central Arizona. Between January 1, 2000, and June 30, 2006, coccidioidomycosis was diagnosed in 1.9% of the overall practice and in 3.1-3.6% of patients with rheumatoid arthritis (RA). The annual incidence was 1%in patients recently diagnosed with RA and 2% among patients with recently initiated infliximab treatment. Coccidioidomycosis was identified only in patients with inflammatory rheumatic diseases and extrathoracic dissemination occurred only to joints in two patients. Corticosteroids, immunosuppressive medications, and tumor necrosis factor inhibitors (TNFIs) appeared to be risk factors for symptomatic, but not disseminated coccidioidomycosis.

Original languageEnglish (US)
Title of host publicationCoccidioidomycosis Sixth International Symposium
PublisherBlackwell Publishing Inc.
Number of pages15
ISBN (Print)1573316881, 9781573316880
StatePublished - Sep 2007

Publication series

NameAnnals of the New York Academy of Sciences
ISSN (Print)0077-8923
ISSN (Electronic)1749-6632


  • Coccidioidomycosis
  • Corticosteroids
  • Disease-modifying antirheumatic drug
  • Immunosuppression
  • Incidence
  • Rheumatoid arthritis
  • Tumor necrosis factor inhibitors

ASJC Scopus subject areas

  • General Neuroscience
  • General Biochemistry, Genetics and Molecular Biology
  • History and Philosophy of Science


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