Cross-Sectional Study of Clinical Predictors of Coccidioidomycosis, Arizona, USA

Emerg Infect Dis. 2022 Jun;28(6):1091-1100. doi: 10.3201/eid2806.212311.

Abstract

Demographic and clinical indicators have been described to support identification of coccidioidomycosis; however, the interplay of these conditions has not been explored in a clinical setting. In 2019, we enrolled 392 participants in a cross-sectional study for suspected coccidioidomycosis in emergency departments and inpatient units in Coccidioides-endemic regions. We aimed to develop a predictive model among participants with suspected coccidioidomycosis. We applied a least absolute shrinkage and selection operator to specific coccidioidomycosis predictors and developed univariable and multivariable logistic regression models. Univariable models identified elevated eosinophil count as a statistically significant predictive feature of coccidioidomycosis in both inpatient and outpatient settings. Our multivariable outpatient model also identified rash (adjusted odds ratio 9.74 [95% CI 1.03-92.24]; p = 0.047) as a predictor. Our results suggest preliminary support for developing a coccidioidomycosis prediction model for use in clinical settings.

Keywords: Arizona; Coccidioides; United States; Valley fever; coccidioidomycosis; diagnosis; fungi; prediction model; respiratory infections; risk factors.

Publication types

  • Review
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Arizona / epidemiology
  • Coccidioides
  • Coccidioidomycosis* / diagnosis
  • Coccidioidomycosis* / epidemiology
  • Cross-Sectional Studies
  • Humans