{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:42:58Z","timestamp":1791582178941,"version":"4.3.4"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T00:00:00Z","timestamp":1744934400000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Diabetes mellitus (DM) is a known risk factor for severe coccidioidomycosis. Central California has some of the highest rates of DM in the USA, according to CDC data. This study examines the impact of glycemic control on the severity and outcomes of coccidioidomycosis in this high-DM-prevalent region. A retrospective analysis was conducted on patients with both coccidioidomycosis and DM from 2014 to 2022 at a large referral center in Fresno, California. Data collected included demographics, presentation, HbA1c levels, management, and outcomes. Fisher\u2019s exact test and the Wilcoxon-Rank sum test were used to analyze categorical and continuous measures, respectively. Logistic regression was applied for binary outcomes. We analyzed 131 patients with coccidioidomycosis and DM (62% male and 64% Hispanic). The median HbA1c at the diagnosis of coccidioidomycosis was 9%. A total of 64% developed complicated pulmonary disease, and 56% cavitary pulmonary disease. Higher HbA1c at diagnosis was associated with increased odds of complicated pulmonary disease (OR\u00a0=\u00a01.40; 95% CI: 1.05, 1.85), cavitary disease (OR\u00a0=\u00a01.43; 95% CI: 1.09, 1.88), and decreased odds of resolution (OR\u00a0=\u00a00.66; 95% CI: 0.48, 0.93). Central California, with one of the highest burdens of coccidioidomycosis, also has an increased prevalence of DM. Our study population had significantly uncontrolled DM. We also found that the level of glycemic control impacted the severity of pulmonary coccidioidomycosis and rates of resolution. Achieving reasonable glycemic control and addressing barriers to effective DM management may be just as crucial as effective antifungal therapy.<\/jats:p>","DOI":"10.1093\/mmy\/myaf039","type":"journal-article","created":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T02:27:21Z","timestamp":1744943241000},"source":"Crossref","is-referenced-by-count":3,"title":["Impact of glycemic control on coccidioidomycosis outcomes in patients with underlying diabetes mellitus in central California"],"prefix":"10.1093","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8443-7095","authenticated-orcid":false,"given":"Geetha","family":"Sivasubramanian","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, University of California , San Francisco, Fresno, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Fox","sequence":"additional","affiliation":[{"name":"UCSF School of Medicine, University of California , San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nam","family":"Huynh","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency Program, University of California , San Francisco, Fresno, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Woodley","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency Program, University of California , San Francisco, Fresno, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alec","family":"Chan-Golston","sequence":"additional","affiliation":[{"name":"School of Social Sciences, Humanities and Arts, Health Sciences Research Institute, University of California , Merced, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Policepatil","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of California , San Francisco, Fresno, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"issue":"2","key":"2025042305120969200_bib1","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1016\/j.idc.2021.03.010","article-title":"Coccidioidomycosis","volume":"35","author":"Bays","year":"2021","journal-title":"Infect Dis Clin North Am"},{"issue":"48","key":"2025042305120969200_bib2","doi-asserted-by":"publisher","first-page":"1817","DOI":"10.15585\/mmwr.mm6948a4","article-title":"Regional analysis of coccidioidomycosis incidence\u2014California, 2000\u20132018","volume":"69","author":"Sondermeyer\u00a0Cooksey","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"6","key":"2025042305120969200_bib3","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1093\/mmy\/myu004","article-title":"Demonstration of Coccidioides immitis and Coccidioides posadasii DNA in soil samples collected from Dinosaur National Monument, Utah","volume":"52","author":"Johnson","year":"2014","journal-title":"Med Mycol"},{"issue":"3","key":"2025042305120969200_bib4","doi-asserted-by":"publisher","first-page":"606","DOI":"10.3201\/eid2603.191536","article-title":"Suspected locally acquired coccidioidomycosis in Human, Spokane, Washington, USA","volume":"26","author":"Oltean","year":"2020","journal-title":"Emerg Infect Dis"},{"issue":"2","key":"2025042305120969200_bib5","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1007\/s40121-022-00606-y","article-title":"Coccidioidomycosis: a contemporary review","volume":"11","author":"Crum","year":"2022","journal-title":"Infect Dis Ther"},{"issue":"3","key":"2025042305120969200_bib6","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1097\/01.md.0000126762.91040.fd","article-title":"Coccidioidomycosis: a descriptive survey of a reemerging disease. 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