October 1975

Disseminated Coccidioidomycosis in a Child

Author Affiliations

Orthopedic Service Veterans Administration Hospital Lexington, KY 40506; Orthopedic and Medical Departments Valley Medical Center Fresno, Calif

Am J Dis Child. 1975;129(10):1237-1238. doi:10.1001/archpedi.1975.02120470077024

In 1964, Ziering and Rockas published a case report of disseminated coccidioidomycosis of a child.1 At the time of the publication, the 24-month-old child had severe disease involving the left knee, right wrist, and right elbow. Treatment with amphotericin B (Fungizone), 2.4 gm administered intravenously during a total hospitalization of 18 months, was ineffective. No operation had been employed. Death was predicted, and the child was lost to follow-up.

We can now report a longer-term follow-up on this child, in order to illustrate the fickle nature of coccidioidomycotic infection and the relative ineffectiveness of our treatment for this condition.

The child's condition improved substantially without further treatment after he left Fresno, Calif, but he developed signs of active local and systemic disease in 1966 at the age of 5. He was admitted to a Galveston, Tex, hospital with obvious synovitis of the left knee and drainage from the right

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