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J. Thorac. Cardiovasc. Surg. · May 1978
Surgery for coccidioidomycosis in 52 diabetic patients with special reference to related immunologic factors.
- E J Baker, J A Hawkins, and E A Waskow.
- J. Thorac. Cardiovasc. Surg. 1978 May 1; 75 (5): 680-7.
AbstractFifty-two diabetic patients who underwent pulmonary surgery for coccidioiodmycosis were evaluated by a retrospective study which included classification by stage of disease, status of insulin dependency, and reaction to coccidioidin skin test. The insulin-dependent diabetic patient had a fourfold increase in the incidence of more severe (progressive) disease. Perioperative therapy with amphotericin B may be of value in the adult surgical candidate with progressive disease but is not necessary or desirable in the juvenile diabetic patient. Coccidioidomycosis is a disease of relative immunocompromise, and a negative skin test should herald such compromise and support a decision for surgery. Such surgery in the progressive stages should be totally extirpative. The presence of inadequately resected disease may adversely affect subsequent immunologic resistance of the host.
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