Blastomycosis, Histoplasmosis, and Coccidioidomycosis in Outpatient Community-Acquired Pneumonia

What proportion of adult outpatients with unspecified community-acquired pneumonia (CAP) underwent diagnostic testing for blastomycosis, coccidioidomycosis, or histoplasmosis, and what proportion tested positive for those diseases?In this cohort study of health insurance claims data, among 573 994 patients with unspecified CAP, 5% underwent fungal diagnostic testing, after a median of 3 health care visits. Among tested patients, 3% received a blastomycosis, coccidioidomycosis, or histoplasmosis diagnosis code.These low testing rates highlight the potential for missed diagnoses of blastomycosis, coccidioidomycosis, and histoplasmosis; increased testing could lead to decreased health care utilization and inappropriate antibiotic use, and improve patient outcomes.

Corresponding Author: Kaitlin Benedict, MPH, Mycotic Diseases Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop H24-9, Atlanta, GA 30329 (jsy8@cdc.gov).

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