1607. Hospitalizations Associated with Coccidioidal Meningitis in Arizona, 2008-2014
Session: Poster Abstract Session: Mycology - There's a Fungus Among Us: Epidemiology
Friday, October 28, 2016
Room: Poster Hall
Posters
  • Khan ID Week 2016 Poster Final.pdf (197.6 kB)
  • Background: Meningitis is among the most devastating forms of coccidioidomycosis. However, the epidemiology of coccidioidal meningitis in Arizona is poorly described, and population-based data are lacking. We described the demographic and clinical characteristics of patients hospitalized with coccidioidal meningitis in Arizona between 2008 and 2014.

    Methods: Discharge records for hospital admissions between 2008 and 2014 with an ICD-9-CM discharge diagnosis code for coccidioidal meningitis (114.2) were obtained from all non-federal facilities in Arizona. Concurrent immunosuppressive conditions (diabetes, HIV/AIDS, pregnancy) were also identified using ICD-9 codes. Demographic characteristics were defined using the initial hospitalization. Analyses were performed using SAS 9.3.

    Results: There were 1,251 hospitalizations associated with coccidioidal meningitis among 623 patients during the study period. The average annual hospitalization rate was 2.74 admissions per 100,000 person-years. No statistically significant temporal trend was observed. Seventy percent (n=433) of patients were male. The mean age at first admission was 47 years. The hospitalization rate among black persons was 4.85 times higher than that in whites (95% CI: 3.29, 7.13). In-hospital mortality was relatively rare: 31 (5%) patients died. Forty three percent of patients (n=267) had a concurrent condition: 20% (n=126) of patients had a diagnosis of HIV/AIDS, and 23% (n=146) had a diagnosis of diabetes. The median length of stay was six days. Sixty one percent of hospitalizations (n=381) involved an ICU stay. Readmission was common (41%) and more likely among black patients (RR 1.63; 95% CI: 1.15, 2.31) and diabetic patients (RR 1.41; 95% CI: 1.07, 1.87).

    Conclusion: Hospitalization associated with coccidioidal meningitis is uncommon in Arizona. Although rarely fatal, the burden of severe, chronic disease is substantial.

    Mohammed Khan, MSPH, Department of Epidemiology, Emory University, Atlanta, GA and Shane Brady, MPH, Arizona Department of Health Services, Phoenix, AZ

    Disclosures:

    M. Khan, None

    S. Brady, None

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