Photo Credit: Carl Lokko

The following is a summary of the study titled “Access to Urgent Care Practices Improves Understanding and Management of Endemic Coccidioidomycosis: Maricopa County, Arizona, 2018-2023,” published in the October 2024 issue of Primary Care by Galgiani et al.

Coccidioidomycosis, commonly known as Valley fever, often goes undiagnosed in endemic regions due to a lack of appropriate testing. To address this, a dashboard was created to track the prevalence of coccidioidomycosis throughout the year.

Banner Urgent Care Service operates numerous clinics in Maricopa County, Arizona, an area with high endemicity for coccidioidomycosis. For this study, researchers analyzed clinic visits between 2018 and 2024 for patients diagnosed with pneumonia (ICD-10 J18.*) or erythema nodosum (ICD-10 L52) and those tested for coccidioidomycosis. Monthly coccidioidomycosis diagnosis data from Banner Urgent Care were compared with confirmed cases reported to the Maricopa County Department of Public Health.

The results showed a strong correlation (r = 0.86) between the monthly frequency of urgent care coccidioidomycosis diagnoses and public health case counts. Testing for coccidioidomycosis was also correlated with the overall frequency of pneumonia cases (r = 0.52). The proportion of pneumonia cases attributable to coccidioidomycosis ranged from less than 5% to over 45%, depending on the time of year. Additionally, coccidioidomycosis was a common cause of erythema nodosum, accounting for 65% of cases (95% CI, 45%-67%), independent of pneumonia. Notably, over half of the coccidioidomycosis diagnoses made at Banner Urgent Care were not associated with either pneumonia or erythema nodosum.

Researchers concluded that the data provided by the coccidioidomycosis dashboard can help urgent care providers better understand when coccidioidomycosis is circulating in the community. The study concluded that patients in endemic areas who present with pneumonia or erythema nodosum should be routinely tested for coccidioidomycosis. The data from private healthcare systems like Banner Urgent Care can play a valuable role in enhancing public health surveillance of the disease.

Source: amjmed.com/article/S0002-9343(24)00268-7/fulltext