Disseminated coccidioidomycosis: Monitoring of serologic markers for treatment response

Dunja Wilmes; Daniela Schui; Jürgen Held; Sina Ackermann; Udo Geipel; Kai Emrich; Ernst-Joachim Winkelmann; Volker Rickerts

doi:10.1016/j.mmcr.2020.05.007

Disseminated coccidioidomycosis: Monitoring of serologic markers for treatment response

Med Mycol Case Rep. 2020 May 30:29:25-28. doi: 10.1016/j.mmcr.2020.05.007. eCollection 2020 Sep.

Authors

Dunja Wilmes¹, Daniela Schui², Jürgen Held³, Sina Ackermann¹, Udo Geipel⁴, Kai Emrich⁵, Ernst-Joachim Winkelmann⁶, Volker Rickerts¹

Affiliations

¹ Robert Koch Institut, FG 16, Seestrasse 10, Berlin, 13353, Germany.
² Bioscientia Institut für Medizinische Diagnostik GmbH, Konrad-Adenauer-Str. 17, 55218, Ingelheim, Germany.
³ Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen und Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Wasserturmstrasse 3/5, 91054, Erlangen, Germany.
⁴ Bioscientia MVZ Saarbrücken GmbH, Winterberg 1, 66119, Saarbrücken, Germany.
⁵ Institut für Pathologie Saarbrücken-Rastpfuhl, Rheinstraße 2, 66113, Saarbrücken, Germany.
⁶ Facharzt für Innere Medizin und Pneumologie, Friedrich-Ebert-Straße 40, 66763, Dillingen/Saar, Germany.

Abstract

We describe a patient with a disseminated coccidioidomycosis. Biomarkers in serum during itraconazole therapy showed a rapid clearing of Coccidioides DNA as detected by PCR. Coccidioides antibody detection by lateral flow assay became negative after one year and decreased from 1:64 to 1:8 in the complement fixation test after two years. The (1 → 3)-ß-D-glucan levels normalised after two years without increase after cessation of antifungal therapy. Biomarkers in serum may guide treatment decisions in disseminated coccidioidomycosis.

Keywords: Coccidioides qPCR; Coccidioidomycosis; Endemic mycosis; Osteomyelitis; travel Related diseases.

Publication types

Case Reports