Coccidioidomycosis is a common
infection in the desert southwestern USA; approximately 3 % of healthy persons in Arizona alone become infected annually.
Coccidioidomycosis may be severe in immunocompromised persons, but experience among patients with solid organ
cancer has not been fully described. Therefore, we aimed to describe the clinical courses of patients whose
cancers were complicated by
coccidioidomycosis at our institution, which is located in an area with endemic Coccidioides. To do so, we conducted a retrospective review from January 1, 2000, through December 31, 2014, of all patients with breast, colorectal, or
ovarian cancer whose
cancer courses were complicated by
coccidioidomycosis. We identified 17,576
cancer patients; 14 (0.08 %) of these patients met criteria for proven or probable
coccidioidomycosis diagnosed within the first 2 years after the
cancer diagnosis. All of these patients had primary pulmonary
coccidioidomycosis, none had relapsed prior
infection, and 1 had possible extrapulmonary dissemination. Five had active coccidioidal
infection during
chemotherapy, 1 of whom was hospitalized for coccidioidal
pneumonia. All were treated with
fluconazole, and all improved clinically. Eleven did not require prolonged courses of
fluconazole. There were no clearly demonstrated episodes of relapsed
infection. In conclusion,
coccidioidomycosis was not a common complication of breast, colorectal, or
ovarian cancers in patients treated at our institution, and it was not commonly complicated by severe or disseminated
infection.