947. Evaluation of Vitamin D Levels in Patients with Coccidioidomycosis, a Case Control Study
Session: Poster Abstract Session: Clinical Mycology
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • Poster_947_IDSA_49_Evaluation of VitD in cocci_Arash_ Heidari.pdf (406.5 kB)
  • Background:  Replacement of inadequate serum Vitamin D 25OH total (VitD) levels have been recently the focus of infectious diseases providers. There is a body of evidence that shows an association between low VitD levels and increase in incidence of several infectious diseases such as tuberculosis. However, to our knowledge there has been no study that evaluated the vitD levels in patients with Coccidioidomycosis.

    Methods:  Retrospective, matched case-control study in population ≥ 18 years old from1990 to 2010 at Kern Medical Center with measured Vitamin D 25OH total levels in ng/ml. VitD deficiency defined as levels <20 ng/ml and levels between 20 and 30 defined as VitD insufficient. Total of 118 cases selected who had positive diagnosis of Coccidioidomycosis by serology (97%), pathology, or cultures (31%). From these cases 35%(42) had pulmonary and 65% had at least one from of dissemination. Mean age of cases was 42.8 with majority being male (63%). Ethnicity was 69% Hispanics followed by 17% African American and 14% Caucasians. Controls were selected from the general patient population without any history or evidence of Coccidioidomycosis infection.  Cases and controls were randomly matched (ratio: 1 to 4) by age, race and sex and evaluated for demographics and co-morbidities. Analysis was performed by SAS JMP.

    Results: Numerical analysis indicated that mean VitD level was statistically lower in controls (22.5 ng/ml) compare to cases (25.9 ng/ml); P=0.0016.The prevalence of VitD insufficiency (20≤VitD<30) was not statistically different between cases and controls; OR = 1.5 {CI95 (0.9, 2.5)} P=0.05. However, it was statistically higher in controls for VitD deficiency (VitD<20); OR = 1.8 {CI95(1.1, 3.1)} P=0.009. Logistical regression analysis showed Diabetes (DM) and Chronic Kidney Disease (CKD) as cofounders. Prevalence of DM OR=1.7{CI95(1.1, 2.7)} P=0.004 and CKD OR=3.7{ CI95(1.8, 7.7)} P=0.0001 were statistically higher in controls compare to cases. After exclusion of DM and CKD from cases and controls no statistical difference between cases and controls for prevalence of VitD deficiency and insufficiency combined were found.  OR=0.95 {CI95(0.6,1.5)} P=0.4.

    Conclusion: There is no association between low vitamin D levels and Coccidioidomycosis


    Subject Category: M. Mycology including clinical and basic studies of fungal infections

    Arash Heidari, M.D.1, John Dickey, M.D.2, Nooshin Jahangiri, M.D.3, Bahareh Ghafarizadeh, M.D.2 and Greti Peterson, M.D.2, (1)Infectious Diseases, Kern Medical Center/UCLA, Bakersfield, CA, (2)Internal Medicine, Kern Medical Center/UCLA, Bakersfield, CA, (3)Family Practice, Kern Medical Center/ UCI, Bakersfield, CA

    Disclosures:

    A. Heidari, Ortho-McNeil: Grant Investigator, Research grant
    Pfizer: Grant Investigator, Research grant

    J. Dickey, None

    N. Jahangiri, None

    B. Ghafarizadeh, Ortho-McNeil: Grant Investigator, Research grant
    Pfizer: Grant Investigator, Research grant

    G. Peterson, None

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