Erythema nodosum in pregnant patients with coccidioidomycosis
Abstract
Pregnant patients with coccidioidomycosis develop dissemination and serious disease more frequently than do the general population. To assist in prognosis and management, we analyzed the significance of erythema nodosum in pregnant patients with coccidioidomycosis. Sixty-one pregnant patients (mean age +/- SD, 26.4 +/- 6.3 years) were evaluated. Seventy percent of the patients were Hispanic; 15%, African American; 13%, Caucasian; and 2%, unknown race. Of the 30 patients (49%) who developed erythema nodosum, 0 had disseminated disease (P = .001), 1 (3%) with pulmonary involvement required therapy for > 1 year, and 29 (97%) recovered (P = .0008). Of the 31 patients (51%) without erythema nodosum, 11 (35%) had disseminated disease, 12 (39%) required therapy for > 1 year, 17 (55%) recovered, 1 (3%) died, and 1 (3%) had an outcome that was unknown. Erythema nodosum appears to be a salient marker of a positive outcome for pregnant patients, more so than for the general population.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Black or African American individuals with coccidioidomycosis have lower rates of erythema nodosum compared to white individuals.
“Also, black or African American individuals with coccidioidomycosis were found to have lower rates compared to white individuals of erythema nodosum, which is an immunological response to the infection that is thought to be protective against coccidioidomycosis [159,160]”
From Race and ethnicity: Risk factors for fungal infections? (2023) · cites this paper as [159]
Erythema nodosum is an immunological response to coccidioidomycosis that is thought to be protective against the infection.
“Also, black or African American individuals with coccidioidomycosis were found to have lower rates compared to white individuals of erythema nodosum, which is an immunological response to the infection that is thought to be protective against coccidioidomycosis [159,160]”
From Race and ethnicity: Risk factors for fungal infections? (2023) · cites this paper as [159]
Cites
Weinberger, S. E., Weiss, S. T., Cohen, W. R., Weiss, J. W., & Johnson, T. S. (1980) · American Review of Respiratory Disease · doi:10.1164/arrd.1980.121.3.559 · Cited by 336 · see citing works
Fluconazole-induced congenital anomalies in three infants
Pursley, T. J., Blomquist, I. K., Abraham, J., Andersen, H. F., & Bartley, J. A. (1996) · Clinical Infectious Diseases · doi:10.1093/clinids/22.2.336 · Cited by 246 · see citing works
Drutz, D. J., & Catanzaro, A. (1978) · PubMed · doi:10.1164/arrd.1978.117.3.559 · Cited by 177 · see citing works
Epidemiology of Acute Coccidioidomycosis with Erythema Nodosum (“San Joaquin” or “Valley Fever”)
SMITH, C. E. (1940) · American Journal of Public Health and the Nations Health · doi:10.2105/ajph.30.6.600 · Cited by 176 · see citing works
Coccidioidomycosis and Pregnancy
PETERSON, C. M., SCHUPPERT, K., Kelly, P. C., & Pappagianis, D. (1993) · Obstetrical & Gynecological Survey · doi:10.1097/00006254-199303000-00002 · Cited by 75 · see citing works
Dissemination of coccidioidomycosis in pregnancy
Smale, L. E., & Waechter, K. G. (1970) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(70)90557-0 · Cited by 73 · see citing works
NILSEN, D. L. F. (1972) · De Gruyter eBooks · doi:10.1515/9783110818536-003 · Cited by 65 · see citing works
Coccidioidomycosis during Pregnancy
Wack, E. E., Ampel, N. M., Galgiani, J. N., & Bronnimann, D. A. (1988) · CHEST Journal · doi:10.1378/chest.94.2.376 · Cited by 63 · see citing works
Coccidioidomycosis complicating pregnancy. Report of 3 cases and review of the literature.
Harris, R. E. (1966) · PubMed · Cited by 45 · see citing works
Coccidioidomycosis in a neonate; maternal-infant transmission
Bernstein, D. I., Tipton, J. R., Schott, S. F., & Cherry, J. D. (1981) · The Journal of Pediatrics · doi:10.1016/s0022-3476(81)80403-9 · Cited by 44 · see citing works
Coccidioidomycosis as a complication of pregnancy.
Vaughan, J. E., & Ramirez, H. (1951) · PubMed · Cited by 43 · see citing works
Pulmonary Mycosis in Pregnant Women
Catanzaro, A. (1984) · CHEST Journal · doi:10.1378/chest.86.3.14s · Cited by 43 · see citing works
Coccidioidomycosis complicating pregnancy
McCoy, M. J., Ellenberg, J. F., & Killam, A. P. (1980) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(15)33252-x · Cited by 43 · see citing works
Fatal maternal disseminated coccidioidomycosis in a nonendemic area
Vanbergen, W. S., FLEURY, F. J., & Cheatle, E. L. (1976) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(76)90075-2 · Cited by 32 · see citing works
Reactivation of coccidioidomycosis in pregnancy.
Walker, M. P. R., Brody, C. Z., & Resnik, R. R. (1992) · PubMed · Cited by 26 · see citing works
Spark, R. P. (1981) · PubMed · Cited by 22 · see citing works
Fatal maternal coccidioidomycosis
Harrison, H. N. (1958) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(58)90662-8 · Cited by 19 · see citing works
Erythema nodosum and coccidioidomycosis.
Dc, W., & Pj, L. (1979) · PubMed · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Almeida‐Paes, R., Oliveira, M. M. E., Freitas, D. F. S., do Valle, A. C. F., Zancopé‐Oliveira, R. M., & Gutierrez‐Galhardo, M. C. (2014) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0003094 · Cited by 192 · see citing works
Aspects of fungal pathogenesis in humans.
van Burik, J. V., & Magee, P. T. (2001) · Annual Review of Microbiology · doi:10.1146/annurev.micro.55.1.743 · Cited by 174 · see citing works
Erythema nodosum and erythema induratum (nodular vasculitis): diagnosis and management
Gilchrist, H., & Patterson, J. W. (2010) · Dermatologic Therapy · doi:10.1111/j.1529-8019.2010.01332.x · Cited by 135 · see citing works
Coccidioidomycosis: A review and update
DiCaudo, D. J. (2006) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2006.04.039 · Cited by 125 · see citing works
Coccidioidomycosis and the skin: a comprehensive review
García-García, S. C., Alanís, J. C. S., Flores, M. G., González, S. E. G., Cabrera, L. V., & Ocampo‐Candiani, J. (2015) · Anais Brasileiros de Dermatologia · doi:10.1590/abd1806-4841.20153805 · Cited by 116 · see citing works
Coccidioidomycosis During Pregnancy: A Review and Recommendations for Management
Bercovitch, R. S., Catanzaro, A., Schwartz, B. S., Pappagianis, D., Watts, D. H., & Ampel, N. M. (2011) · Clinical Infectious Diseases · doi:10.1093/cid/cir410 · Cited by 106 · see citing works
Welsh, O., Cabrera, L. V., Rendón, A., González, G. M., & Bonifáz, A. (2012) · Clinics in Dermatology · doi:10.1016/j.clindermatol.2012.01.003 · Cited by 81 · see citing works
Influenza and Pneumonia in Pregnancy
Laibl, V. R., & Sheffield, J. S. (2005) · Clinics in Perinatology · doi:10.1016/j.clp.2005.04.009 · Cited by 76 · see citing works
Coccidioidomycosis in African Americans
Ruddy, B. E., Mayer, A. P., Ko, M. G., Labonte, H. R., Borovansky, J. A., Boroff, E. S., & Blair, J. E. (2011) · Mayo Clinic Proceedings · doi:10.4065/mcp.2010.0423 · Cited by 65 · see citing works
Race and ethnicity: Risk factors for fungal infections?
Jenks, J. D., Aneke, C. I., Al-Obaidi, M. M., Egger, M., Garcia, L., Gaines, T., Hoenigl, M., & Thompson, G. R. (2023) · PLOS Pathogens · doi:10.1371/journal.ppat.1011025 · Cited by 55 · see citing works
Erythema nodosum associated with sporotrichosis
Galhardo, M. C. G., Schubach, A. D. O., Barros, M. B. D. L., Blanco, T. C. M., Cuzzi‐Maya, T., Schubach, T. M. P., Lazéra, M. D. S., & do Valle, A. C. F. (2002) · International Journal of Dermatology · doi:10.1046/j.1365-4362.2002.01381_2.x · Cited by 39 · see citing works
Coccidioidomycosis in Pregnancy During an Epidemic in California
Caldwell, J. W., ARSURA, E. L., KILGORE, W. B., GARCIA, A. L., REDDY, V., & JOHNSON, R. H. (2000) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(99)00484-6 · Cited by 38 · see citing works
Self-citationInfectious diseases of the skin
Grayson, W. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4160-5649-2.00018-4 · Cited by 30 · see citing works
Coccidioidomycosis and Pregnancy
Spinello, I. M., Johnson, R. H., & Baqi, S. (2007) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1406.008 · Cited by 23 · see citing works
Protective effects of erythema nodosum in coccidioidomycosis
Braverman, I. M. (1999) · The Lancet · doi:10.1016/s0140-6736(05)77213-5 · Cited by 21 · see citing works
Bouton, M. E., Winton, L. M., Gandhi, S. G., Jayaram, L., Patel, P. N., Neill, P. J. O., & Komenaka, I. K. (2015) · International Journal of Surgery Case Reports · doi:10.1016/j.ijscr.2015.02.051 · Cited by 18 · see citing works
Chronic Cavitary Infections Other than Tuberculosis
Holt, M. R., & Chan, E. D. (2018) · Journal of Thoracic Imaging · doi:10.1097/rti.0000000000000345 · Cited by 13 · see citing works
Combating opportunistic infections: coccidioidomycosis
Ampel, N. M. (2004) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.5.2.255 · Cited by 11 · see citing works
Shehab, Z. M. (2010) · Advances in Pediatrics · doi:10.1016/j.yapd.2010.08.008 · Cited by 10 · see citing works
Ampel, N. M. (2010) · Springer eBooks · doi:10.1007/978-1-4419-6640-7_20 · Cited by 8 · see citing works
The Known and Unknown “Knowns” of Human Susceptibility to Coccidioidomycosis
Hsu, A. P. (2024) · Journal of Fungi · doi:10.3390/jof10040256 · Cited by 5 · see citing works
A 19-Year-Old Pregnant Woman With a Skin Lesion and Respiratory Failure
Spinello, I. M., & Johnson, R. H. (2006) · CHEST Journal · doi:10.1378/chest.130.2.611 · Cited by 5 · see citing works
Maves, R. C., & Crum‐Cianflone, N. F. (2011) · Infectious Diseases in Clinical Practice · doi:10.1097/ipc.0b013e31823c4b85 · Cited by 3 · see citing works
Pregnancy Changes Predisposing to Infections
Mehta, S., & Mann, A. (2022) · Springer eBooks · doi:10.1007/978-981-16-7865-3_2 · Cited by 3 · see citing works
Rapini, R. P. (2009) · Elsevier eBooks · doi:10.1016/b978-1-4160-4224-2.50057-0 · Cited by 3 · see citing works
Diseases of the Respiratory System
de Swiet, M. (2002) · doi:10.1002/9780470752371.ch1 · Cited by 3 · see citing works
Effect of Pregnancy on Other Skin Disorders
Jones, S. V., & Black, M. M. (2008) · Elsevier eBooks · doi:10.1016/b978-0-7234-3445-0.10010-4 · Cited by 2 · see citing works
Exhausted T cell phenotypes in disseminated coccidioidomycosis
Whitehill, G. D., Stephens, A. V., Thauland, T. J., Lastre, M. A. M., Tate, M., Beyhan, S., Johnson, R. H., Thompson, G. R., Garcia-Lloret, M., & Butte, M. J. (2026) · JCI Insight · doi:10.1172/jci.insight.203270 · Cited by 1 · see citing works
Mayer, A. P., Files, J. A., & Biria, N. (2012) · Journal of Women s Health · doi:10.1089/jwh.2012.3710 · Cited by 1 · see citing works
Shehab, K. W., & Shehab, Z. M. (2025) · Elsevier eBooks · doi:10.1016/b978-0-323-82763-8.00218-1 · Cited by 1 · see citing works
Coccidioidomycosis: skin manifestations and hypersensitivity syndromes
Mejía-Jiménez, M., & Cardona-Castro, N. M. (2016) · CES Medicina · doi:10.21615/cesmedicina.30.2.6 · Cited by 1 · see citing works
Bacterial, Fungal, and Parasitic Disease
Savoia, M. C. (2004) · Elsevier eBooks · doi:10.1016/b978-0-7216-0435-0.50020-1 · Cited by 1 · see citing works
Afsarmanesh, N., Nayeb‐Hashemi, H., & Landovitz, R. J. (2010) · Journal of Hospital Medicine · doi:10.1002/jhm.608
Coccidioidomycosis and erythema nodosum in pregnancy
Usta, Y., & Shealey, W. (2013) · International Journal of Case Reports and Images · doi:10.5348/ijcri-2013-04-295-cr-4
González-Álvarez, T., & Cardona-Castro, N. M. (2010)
Erythema Nodosum Bodes Well for Coccidioidomycosis During Pregnancy.
Zuger, A. (1998) · Journal watch · doi:10.1056/jw199811200000004
Shehab, Z. M. (2009) · Elsevier eBooks · doi:10.1016/b978-1-4160-4044-6.50218-1
Georgiev, V. S. (2003) · Humana Press eBooks · doi:10.1007/978-1-59259-296-8_31
Yang, Y. W., & DiCaudo, D. J. (2024) · Updates in clinical dermatology · doi:10.1007/978-3-031-57836-6_15
- Authors
- Arsura, E. L., Kilgore, W. B., & Ratnayake, S. N.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Arsura, Edward L.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 1998-11
- Volume
- 27
- Issue
- 5
- Pages
- 1201-1203
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2026182694
- Cited by
- 40
- References
- 18
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2018: 1 · 2016: 1 · 2015: 2 · 2014: 1 · 2013: 1 · 2012: 3
- FWCI
- 1.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
- Health Sciences › Medicine › Epidemiology › Pneumocystis jirovecii pneumonia detection and treatment
- Health Sciences › Medicine › Microbiology › Actinomycetales infections and treatment
- Keywords
- erythema nodosum, coccidioidomycosis, pregnancy, disseminated coccidioidomycosis, prognosis, clinical outcomes, pulmonary coccidioidomycosis, treatment duration
- MeSH terms
- Adult, Antifungal Agents, Coccidioidomycosis, Erythema Nodosum, Female, Humans, Pregnancy, Pregnancy Complications, Infectious, Prognosis, Retrospective Studies, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
