A previously healthy 4-year-old boy with no prior serious illnesses was diagnosed with disseminated coccidioidomycosis with prominent skin and bone involvement. Despite treatment with liposomal amphotericin B, antifungal azoles, and surgical debridement, the patient developed progressive disease. Treatment with interferon-gamma slowed disease progression, and later treatment with interleukin-4 and interleukin-13 blockade induced remission of his infection.
The incidence of pediatric coccidioidomycosis in California has increased significantly from 2000 until 2012, along with hospitalization for complicated disease. Latino children were most commonly infected, but African-American children were significantly more likely to be hospitalized.