Clinician Practice Patterns That Result in the Diagnosis of Coccidioidomycosis Before or During Hospitalization.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Jie PuJ N Galgiani

Abstract

Coccidioidomycosis (CM) is common and important within endemic regions, requiring specific testing for diagnosis. Long delays in diagnosis have been ascribed to ambulatory clinicians. However, how their testing practices have impacted patient care has not been systematically unexplored. We analyzed practice patterns for CM diagnoses over 3 years within a large Arizona healthcare system, including diagnosis location, patient characteristics, and care-seeking patterns associated with missed diagnosis. For 2043 CM diagnoses, 72.9% were made during hospital admission, 21.7% in ambulatory clinics, 3.2% in emergency units, and only 0.5% in urgent care units. A 40.6% subgroup of hospitalized patients required neither intensive care unit or hospital-requiring procedures, had a median length of stay of only 3 days, but still incurred both substantial costs ($27.0 million) and unnecessary antibiotic administrations. Prior to hospital diagnosis (median of 32 days), 45.1% of patients had 1 or more visits with symptoms consistent with CM. During those visits, 71.3% were not tested for CM. Diagnoses were delayed a median of 27 days. Lack of testing for CM in ambulatory care settings within a region endemic for CM resulted in a large number o...Continue Reading

References

Jul 1, 1990·Clinical Microbiology Reviews·D Pappagianis, B L Zimmer
Aug 11, 2004·Archives of Internal Medicine·Tara Bridget GiblinUNKNOWN CDC Campaign to Prevent Antimicrobial Resistance Team
May 19, 2006·Emerging Infectious Diseases·Lisa ValdiviaJohn N Galgiani
Apr 19, 2008·The Journal of Infectious Diseases·John N Galgiani
Jul 5, 2008·Emerging Infectious Diseases·Douglas C ChangBenjamin J Park
Feb 26, 2009·Emerging Infectious Diseases·Michelle M KimJerry D Smilack
Oct 30, 2010·Emerging Infectious Diseases·Clarisse A TsangRebecca H Sunenshine
Jan 8, 2016·Infectious Disease Clinics of North America·Nathan W Stockamp, George R Thompson
Jul 30, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·John N GalgianiNicholas Theodore
Jan 7, 2017·Implementation Science : IS·Bhupendrasinh F ChauhanRyan Zarychanski
Mar 2, 2017·Implementation Science : IS·Divya M GuptaDavid C Aron
Aug 12, 2017·Clinics in Chest Medicine·Luke M GabeKenneth S Knox
Aug 16, 2017·Diagnostic Microbiology and Infectious Disease·Rana ShahabJaffar A Al-Tawfiq
Sep 6, 2017·Pediatrics·Monika K GoyalUNKNOWN Pediatric Care Applied Research Network (PECARN)
Oct 20, 2017·JAMA : the Journal of the American Medical Association·Jeffrey A LinderJason N Doctor
Dec 12, 2017·Medical Mycology·Mohammed A KhanKen K Komatsu
May 29, 2018·BMJ Case Reports·Marie A ManningAndrew M Yeager
Jul 18, 2018·Emerging Infectious Diseases·Kaitlin BenedictBrendan R Jackson
Nov 14, 2018·BMJ : British Medical Journal·Laura M KingLauri A Hicks
Jan 29, 2019·Medical Mycology·Orion Z McCotterRebecca Sunenshine
Mar 31, 2019·International Journal of Environmental Research and Public Health·Leslie WilsonPaul Brown
Aug 24, 2019·Emerging Infectious Diseases·Fariba M DonovanJohn N Galgiani
Oct 19, 2019·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Kabir YadavLarissa May

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Citations

Aug 21, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Fariba M DonovanJohn N Galgiani
Feb 13, 2021·Open Forum Infectious Diseases·Amy J GrizzleJohn N Galgiani

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