Combating opportunistic infections: Coccidioidomycosis

Neil M. Ampel

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations


Coccidioidomycosis is a growing problem in the southwestern US. Although most cases of symptomatic coccidioidomycosis occur in healthy individuals, individuals with depressed cellular immunity are at particular risk. These include individuals with HIV infection, those who have undergone allogeneic transplantation and others on immunosuppressive medications. Most instances of primary pulmonary coccidioidomycosis do not require antifungal therapy. However, almost all cases of disseminated coccidioidomycosis will require such therapy. The triazole antifungals, fluconazole and itraconazole, are effective therapies for coccidioidomycosis. Amphotericin B is now reserved for severe or recalcitrant cases. Coccidioidal meningitis requires life-long therapy with triazole antifungals. Intrathecal amphotericin B is required for those cases that fail. Prevention of coccidioidomycosis by environmental control is difficult. In the future, immunisation or immune modulation may offer protection.

Original languageEnglish (US)
Pages (from-to)255-261
Number of pages7
JournalExpert Opinion on Pharmacotherapy
Issue number2
StatePublished - Feb 2004


  • Amphotericin B
  • Coccidioides
  • Coccidioidomycosis
  • Triazoles

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)


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