{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:31:08Z","timestamp":1790818268429,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2007,10,10]],"date-time":"2007-10-10T00:00:00Z","timestamp":1191974400000},"content-version":"vor","delay-in-days":39,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of the New York Academy of Sciences"],"published-print":{"date-parts":[[2007,9]]},"abstract":"<jats:p><jats:bold><jats:sc>Abstract<\/jats:sc>:\u2002<\/jats:bold>  <jats:bold>Coccidioidomycosis is a fungal infection common in the southwestern United States that is caused by the endemic <jats:italic>Coccidioides<\/jats:italic> species of fungus. Coccidioidal infections are generally manifested as self\u2010limited respiratory illnesses, but affected patients rarely present with coccidioidomycosis in extrapulmonary locations. Skin and soft\u2010tissue coccidioidomycosis may occur in 15% to 67% of patients with disseminated infection. Skin manifestations of coccidioidomycosis can either be reactive rashes, such as erythema multiforme or erythema nodosum associated with primary pulmonary infection, or they can be the result of extrapulmonary dissemination of the infection to the skin. As many as 90% of persons with disseminated infection to the skin have other extrapulmonary sites of infection, and the presence of coccidioidal skin lesions should prompt an investigation for other extrapulmonary foci of infection. Lymph nodes are a common site of extrapulmonary infection. Nearly every organ system and soft\u2010tissue have been described as infected with Coc<jats:italic>cididioides<\/jats:italic> species, but subcutaneous abscesses, phlegmon, and sinus tracts are not uncommon and often are themselves the result of coccidioidal infection in neighboring lymph nodes, bones, or joints. A biopsy of the abnormal area is the most direct way to diagnose skin and soft\u2010tissue lesions. Fluconazole and itraconazole are preferred therapeutic agents, and surgical intervention may be required as an adjunctive measure. This article reviews the types and locations of disseminated infections, as well as diagnostic studies and treatment of this difficult\u2010to\u2010treat manifestation of coccidioidomycosis.<\/jats:bold> <\/jats:p>","DOI":"10.1196\/annals.1406.010","type":"journal-article","created":{"date-parts":[[2007,10,17]],"date-time":"2007-10-17T22:34:18Z","timestamp":1192660458000},"page":"411-421","source":"Crossref","is-referenced-by-count":47,"title":["State\u2010of\u2010the\u2010Art Treatment of Coccidioidomycosis"],"prefix":"10.1111","volume":"1111","author":[{"given":"JANIS E.","family":"BLAIR","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,10,10]]},"reference":[{"key":"e_1_2_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0891-5520(02)00040-5"},{"key":"e_1_2_4_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000126762.91040.fd"},{"key":"e_1_2_4_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-1712-9_9"},{"key":"e_1_2_4_5_2","first-page":"653","article-title":"Coccidioidomycosis: a study of 95 cases of the disseminated type with special reference to the pathogenesis of the disease","author":"Forbus W.D.","year":"1946","journal-title":"Mil. Surg."},{"key":"e_1_2_4_6_2","first-page":"13","article-title":"Association between facial cutaneous coccidioidomycosis and meningitis","volume":"169","author":"Arsura E.L.","year":"1998","journal-title":"West. J. Med."},{"key":"e_1_2_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(03)00462-6"},{"key":"e_1_2_4_8_2","first-page":"233","article-title":"Primary cutaneous coccidioidomycosis: the criteria for diagnosis and a report of a case","volume":"79","author":"Wilson J.W.","year":"1953","journal-title":"Calif. Med."},{"key":"e_1_2_4_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000236953.95213.ac"},{"key":"e_1_2_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(92)70011-4"},{"key":"e_1_2_4_11_2","doi-asserted-by":"publisher","DOI":"10.1086\/496991"},{"key":"e_1_2_4_12_2","doi-asserted-by":"publisher","DOI":"10.1086\/430303"},{"key":"e_1_2_4_13_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-198326040-00004"},{"key":"e_1_2_4_14_2","unstructured":"Stiller R.L. R.Defelice C.Brass et al.1980.Therapy of cutaneous coccidioidomycosis with imadazoles: comparison of results with miconazole and ketoconazole.Proceedings of the 5th International Conference on the Mycoses: Superficial Cutaneous and Subcutaneous Infections.Pan. Am. J. Public. Health396:375\u2013381."},{"key":"e_1_2_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(83)90515-6"},{"key":"e_1_2_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(88)90143-X"},{"key":"e_1_2_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(90)70261-F"},{"key":"e_1_2_4_18_2","first-page":"282","article-title":"NAIAD MycosesStudy Group. 1990. Itraconazole treatment of coccidioidomycosis","volume":"89","author":"Graybill J.R.","journal-title":"Am. J. Med."},{"key":"e_1_2_4_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/14.Supplement_1.S68"},{"key":"e_1_2_4_20_2","doi-asserted-by":"publisher","DOI":"10.1080\/02681219480000151"},{"key":"e_1_2_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(99)80371-4"},{"key":"e_1_2_4_22_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-133-9-200011070-00009"},{"key":"e_1_2_4_23_2","unstructured":"Johnson R.H.&D.Caldwell.1996.State of the art lecture: extra\u2010pulmonary nonmeningeal coccidioidomycosis.InCoccidioidomycosis. Proceedings of the 5th International Conference on Coccidioidomycosis. 1994 Aug. 24\u201327.H.Einstein Ed.:347\u2013358. National Foundation for Infectious Diseases . Washington DC ."},{"key":"e_1_2_4_24_2","volume-title":"Coccidioidomycosis","author":"Fiese M.J.","year":"1958"}],"container-title":["Annals of the New York Academy of Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1196%2Fannals.1406.010","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/nyaspubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1196\/annals.1406.010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T14:00:55Z","timestamp":1695650455000},"score":1,"resource":{"primary":{"URL":"https:\/\/nyaspubs.onlinelibrary.wiley.com\/doi\/10.1196\/annals.1406.010"}},"subtitle":["Skin and Soft\u2010Tissue Infections"],"short-title":[],"issued":{"date-parts":[[2007,9]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2007,9]]}},"alternative-id":["10.1196\/annals.1406.010"],"URL":"https:\/\/doi.org\/10.1196\/annals.1406.010","archive":["Portico"],"relation":{},"ISSN":["0077-8923","1749-6632"],"issn-type":[{"value":"0077-8923","type":"print"},{"value":"1749-6632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,9]]}}}