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Boletín Clínico de la Asociación Médica del Hospital Infantil del Estado de Sonora

2008, Number 2

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Bol Clin Hosp Infant Edo Son 2008; 25 (2)

Coccidioidomicosis Diseminada con Afección Osteoarticular: Experiencia del Hospital Infantil del Estado de Sonora, 1979-2004.

Cano-Rangel MA, Álvarez-Hernández G, Contreras-Soto J, Dórame-Castillo R, Peralta-Valdez I

Language: Spanish
References: 32
Page: 63-70
PDF size: 0. Kb.


ABSTRACT

Objective: To describe the clinical and epidemiological features of osteoarticular coccidioidomycosis (OAC) in children. Material and Methods: A cross-sectional study was carried out in a series of 21 pediatric cases from the period 1979-2004 diagnosed at the Sonora State Children’s Hospital. One case was defined by clinical features and histopathological or serological findings. Demographic and clinical manifestations were described. Results: The prevalence of OAC was of 1.7/100,000 medical discharges. The cases constituted 19% of the registered incidence of coccidioidomycosis in this hospital, far above of the 1% reported by previous studies. There was a slight predominance in males (12) and the age of study subject ranged from 5 months to 15 years old. Clinical findings included local edema (90%), fever (43%), artrhalgia (43%), adenopathy (29%), dermatitis (24%) and weight loss (19%). Bone involvement was observed in 48% of the cases, while pure joint lesion occurred in 29% of the patients. Twenty-three percent of the subjects had simultaneous osteoarticular involvement. Knee (17%) was the joint more frequently damaged by the fungus. Laboratory findings included positivity to intradermal reaction (71%), serological IgM (19%), as well as serological positivity to IgG (51%). OAC was corroborated through biopsy in 86% of the cases. Conclusion: This review supports the need of improving medical knowledge about osteoarticular spread of coccidioidomycosis in children living in endemic areas.


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