Sondermeyer Gail L, Lee Lauren A, Gilliss Debra, Vugia Duc J
California Department of Public Health, Infectious Diseases Branch, Richmond, CA.
Public Health Rep. 2016 Jul-Aug;131(4):531-5. doi: 10.1177/0033354916662210.
The number of cases of coccidioidomycosis and associated hospitalizations increased in California during 2000-2013. During that period, a total of 1,098 death records listed coccidioidomycosis as a cause, averaging 78 deaths annually (range: 43-108). The death rate peaked in 2006 and was significantly higher among males than among females, among African American patients than among white patients, and among residents of the coccidioidomycosis-endemic region of California than among residents of the less endemic regions (p<0.001). A higher death rate was associated with increasing age and was highest (8.8 per 1 million population) among adults aged ≥75 years. Of coccidioidomycosis-associated deaths, 31.9% had a contributing cause of death of severe/disseminated disease, 31.8% of unspecified -coccidioidomycosis, and 28.3% of pulmonary unspecified coccidioidomycosis, per International Classification of Diseases codes. Diabetes was a contributing cause in 19.3% of deaths, and other immunocompromising conditions were a contributing cause in 15.9% of deaths. Populations at higher risk for coccidioidomycosis--associated deaths are similar to those at higher risk for coccidioidomycosis-associated hospitalizations and infection. Awareness for coccidioidomycosis among these groups and their providers is important for proper diagnosis and care.
2000 - 2013年期间，加利福尼亚州球孢子菌病病例数及相关住院人数有所增加。在此期间，共有1098份死亡记录将球孢子菌病列为死因，年均死亡78例（范围：43 - 108例）。死亡率在2006年达到峰值，男性死亡率显著高于女性，非裔美国患者高于白人患者，加利福尼亚州球孢子菌病流行地区居民高于低流行地区居民（p<0.001）。死亡率随年龄增长而升高，≥75岁成年人中死亡率最高（每百万人口8.8例）。根据国际疾病分类编码，在与球孢子菌病相关的死亡病例中，31.9%的促成死因是重症/播散性疾病，31.8%为未指明的球孢子菌病，28.3%为肺部未指明的球孢子菌病。糖尿病是19.3%死亡病例的促成死因，其他免疫功能低下状况是15.9%死亡病例的促成死因。与球孢子菌病相关死亡风险较高的人群与球孢子菌病相关住院和感染风险较高的人群相似。提高这些人群及其医疗服务提供者对球孢子菌病的认识，对于正确诊断和治疗至关重要。
