Coccidioides
has been in the news lately. It is causing havoc in the California DOC causing
them to have to relocate many prisoners and the rates of diagnosis is
increasing as primary care providers are educated on the characteristics of the
infection. Annually as many as 150000 people are infected in the US. Most of
these people are in the southwest. Rep Kevin McCarthy of California is asking
the FDA to add Coccidioides to the list of qualifying pathogens so that
it will e more attractive for medical research and better treatments are cures
can be found. Currently the standard for diagnosis is fungal culture. This culture
can take up to 28 days and is difficult to perform. A recent study,1
evaluated the ability of PCR detection. In this study the sensitivity and
positive predicative value and determined that though they have improved in the
last few years they are at 75 and 60% similar with the standard culture
methods. Though the positive rates are low the negative predictive value and
specificity are each 99%. As these tests are developed they will become cheaper
and doctors will become more comfortable is can be used as a test to exclude
the diagnosis of Coccidioides.
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