Coccidioidomycosis-Associated Deaths in California, 2000–2013

Abstract

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.