Supplemental Material s5

Supplemental MaterialSupp. Table 1. Pregnant patients with disseminated coccidioidomycosisAs: Asian, B: Black, L: Latina, Nat Am: Native American, NR: Not reported, PP: Post-Partum, W: WhiteCase No. First Author/Reference Age (y) R Trimester Sites of Disease Fetal Maternal Outcome No. a Outcome1 Mendenhall (1) 30 W 1 Pulmonary, probable Died, no Died at 5 mo meninges, kidney, liver infection gestation2 Smale (2) 37 B NR Pulmonary, skin, Stillborn Died, day 3 PP meninges, bone, soft tissue 3 Smale (2) 28 B 3 Pulmonary, meninges Died, Died, day 1 PP prematurity4 Smale (2) 34 B 3 Pulmonary, meninges Healthy, Survived survived 5 Smale (2) 27 B 3 Pulmonary (miliary), Died, Died, third trimester spleen undelivered, no infection6 Conan (3) 30 W PP Uterine, skin, fungemia Healthy, Died 2 years PP survived 7 Vaughn (4) 20 B 1 Skin Spontaneous Died abortion 8 Vaughn (4) 34 L 2 Meninges Healthy, Survived survived 9 Vaughn (4) 22 B 2 Meninges, skin Died, Died prematurity, no infection1 Odio 2 10 Vaughn (4) 29 W 3 Disseminated, site not Healthy, Died reported survived 11 Vaughn (4) 31 W 3 Disseminated, site not Healthy, Died reported survived 12 Vaughn (4) 24 A 3 Meninges Healthy, Died survived 13 Vaughn (4) 37 B 3 Disseminated, site not Stillborn, no Died reported infection14 Vaughn (4) 28 B 3 Disseminated, site not Healthy, Died reported survived 15 Vaughn (4) 27 B 3 Disseminated, site not Died, no Died, undelivered reported infection16 Vaughn (4) 19 B 3 Disseminated, site not Healthy, Died reported survived 17 Cohen (5) 22 B 2 Pulmonary (miliary), Died, Died, 14 days PP skin, bone immature, no infection18 Cohen (5) 34 B 2 Pulmonary (miliary), Spontaneous Died at childbirth meninges, skin abortion, no infection19 Baker (6) 32 W 3 Pulmonary, meninges, Healthy, Died, 9 days PP brain parenchyma survived 20 Harrison (7) 20 W 2 Pulmonary, skin, Immature, died Died meninges 21 Mongan (8) 21 W 2 Pulmonary, liver, Died before Died in second urinary birth trimester2 22 Harris (9) 22 W 3 Pulmonary (miliary), Healthy, Died liver survived 23 Harris (9) 38 W 3 Pulmonary (miliary), Healthy, Died liver survived 24 Harris (9) 21 B 2 Bone Healthy, Survived survived 25 Hadsall (10) 38 L 3 Skin Healthy, Survived survived 26 Hadsall (10) 26 B Skin Spontaneous Survived abortion; second pregnancy survived27 Purtilo (11) 22 W 3 Pulmonary, meninges, Immature, died Died liver 28 VanBergen (12) 27 W 2 Pulmonary (miliary), Healthy, Died meninges, fungemia survived 29 Steele (13) 17 W Pulmonary, meninges Healthy, Survived survived 30 Shafai (14) 35 B 3 Pulmonary, Twins died of Died 1 day PP disseminated infection and prematurity31 McCaffree20 (15) 34 N 2 Pulmonary, skin Healthy, SurvivedR survived 32 McCaffree20 (15) NR N 3 Meninges Healthy, SurvivedR survived 33 Bernstein (16) 32 A 3 Cervix Died of Survived infection 34 Salgia (17) 33 L Uterine Healthy, Survived survived 3 Odio 4 35 Wack (18) 28 W 2 Skin Healthy, Survived survived 36 Wack (18) 26 W Pulmonary, meninges Healthy, Survived survived 37 Babycos (19) 21 B 3 Pulmonary, skin, bone Born Died PP marrow, heart prematurely, healthy, no infection38 Lee (20) 19 B 3 Disseminated, No mention of Survived meninges outcome of first pregnancy; second infant born prematurely with fluconazole- related defects; no infection39 Pursley (21) 22 N 3 Disseminated Four SurvivedR pregnancies: two healthy and two with fluconazole tetragonic finding 40 Aleck (22) 27 L 3 Meninges Healthy, Survived survived4 41 Charlton (23) 20 L 3 Pulmonary, Pneumonia, Died disseminated to liver, survived placenta 42 Crum (24) 21 L 3 Pulmonary (miliary), Healthy, Survived bone, skin survived 43 Arnold (25) 30 L 3 Placenta Healthy, Survived survived 44 Hooper (26) 27 N 2 Placenta Died Survived45 Anstead (27) 24 RB 2 Disseminated, site not Died Survived reported 46 Cunningham (28) 31 N 2 Meninges Elective SurvivedR abortion 47 Crum (29) 24 A Skin Healthy, Survived survived 48 Calderon (30) 22 L 3 Meninges Healthy, Died survived 49 Calderon (30) 23 L 3 Meninges Healthy, Died survived 50 Calderon (30) 24 L 2 Meninges and CNS Healthy, Died abscess, survived lymphadenitis, soft tiss 51 Calderon (30) 27 L 3 Soft Tissue Died Died 52 Peterson (31) 21 B NR Skin Died Survived5 Odio 6Supp. Table 2. Patients with exogenous immunosuppression and disseminated coccidioidomycosisAs: Asian, B: Black, L: Latino/a, Nat Am: Native American, NR: Not reported, W: WhiteCase First Age (Y) Reason for Medication/Dose Reduct Symptom Pulmonar Location of Final No. Author Immunosuppressio ion or improvement < 1 mo y Disease Dissemination Outcome n withdra after reduction or wal of withdrawal of immun immunosuppression osuppr ession 1 Bravo (32) 16 ALL COG AALL0232 protocol Intrathe Y N Appendicular Survived cal osteomyelitis, methotr cutaneous, exate meninges continu ed; 5- day prednis one pulses were d/c for 3 months 2 Bravo (32) 20 ALL COG AALL0232 protocol Off N/A N Axial Survived therapy osteomyelitis, for 8 cutaneous, soft months tissue at time of 6 fungal present ation 3 Bravo (32) 6 Symptomatic Prednisone, 5 day course/ dose NR Y N Y Blood, axial Died treatment of fatigue, osteomyelitis, soft fevers, weight loss tissue (2 or more locations) 4 Blodget 23 Kidney transplant Anti-thymocyte globulin (1 mg/kg daily NR NR Y Blood, soft tissue Survived(33) for 4 days), tacrolimus 1 mg q 12 h, MMF 500 mg b.i.d., methylprednisolone5 Blodget 66 Heart transplant MMF 1500 mg b.i.d., prednisone 10 mg NR, NR Y Blood, soft tissue Died(33) b.i.d., tacrolimus 2 mg AM and 1 mg PM. died 6 (2 or more days locations) after CM diagnos is 6 Blodget 40 Kidney transplant MMF 500mg daily, prednisone 10 mg NR, NR Y Blood, soft tissue Died(33) daily, tacrolimus 3mg q AM and 4mg q died 5 (2 or more PM days locations) after CM diagnos is 7 Dierberg 19 Kidney transplant Tacrolimus, prednisone, MMF/ dose NR NR NR Y Blood Survived(34) 8 Dierberg 45 Kidney/pancreas Tacrolimus, prednisone, MMF/ dose NR NR, CM NR Y Blood Died(34) transplant was diagnos7 Odio 8 ed postmor tem 9 Keckich 49 Kidney transplant Thymoglobulin, tacrolimus, prednisone/ NR NR Y Meninges Survived(35) dose NR 10 Keckich 64 Liver transplant Tacrolimus, prednisone/ dose NR NR NR Y Soft tissue Survived(35) 11 Kokseng 18 Kidney transplant MMF, tacrolimus/ dose NR MMF Y N Cutaneous, Survived(36) d/c, meninges tacrolim us dose decreas ed 12 Mitter (37) 50 Crohn’s disease 100 mg 6-mercaptopurine daily, Both N Y Appendicular Died adalimumab/ dose NR were osteomyelitis, d/c cutaneous, meninges and CNS abscess, soft tissue 13 Carvalho 62 Kidney transplant Cyclosporine and prednisolone/ dose Doses N N CNS abscess Died(38) NR of both were reduced 14 Keckich 74 Type of malignancy Steroids/ dose NR NR NR Y Blood Survived(39) NR 15 Keckich 79 Rheumatoid arthritis Azathioprine/ dose NR NR NR Y Blood Died(39) 16 Keckich 66 Dermatomyositis Steroids/ dose NR NR NR Y Blood Survived(39) 17 Trentman 37 Sarcoidosis Prednisone/ dose NR NR NR N Appendicular Survived(40) osteomyelitis, 8 cutaneous18 Wollina 52 Sarcoidosis Prednisolone and methotrexate (MTX) / Both Y Y Cutaneous Survived(41) dose NR were d/c 19 Stagliano 3 Wilms' tumor Chemotherapy for tumor/ medications No N/A Y Blood, cutaneous, Survived(42) and doses NR soft tissue 20 Kappel 48 HIV N/A Viral N/A Y Cutaneous Survived(43) load and CD4 count were NR 21 Assi (44) 64 Liver transplant Corticosteroids/ dose NR NR NR Y Appendicular Survived osteomyelitis 22 Sohail (45) 72 Arachnoiditis Dexamethasone/dose NR NR NR Y Soft tissue Died of other cause 23 Sohail (45) 56 Kidney transplant Prednisone, azathioprine, cyclosporine/ NR NR Y Soft tissue Died of dose NR other cause 24 Ugurlu (46) 77 Suspected giant cell High dose prednisone/ dose NR Prednis NR N Cutaneous, soft Survived arteritis one tissueD/C 25 Wang (47) 71 Intermittent fever Prednisolone/ 30 mg/day NR NR Y Blood, meninges Died 26 Glenn (48) 42 GVHD prophylaxis Cyclosporine methotrexate/ dose NR No N/A Y Axial Died of and control after Prednisone/ 120 mg/day osteomyelitis, other HSCT for chronic blood, cause myelogenous lymphadenitis, leukemia soft tissue (2 or 9 Odio 10 more locations)27 Blair (49) 60 Kidney transplant Prednisone 15 mg daily, tacrolimus 2 mg NR NR Y Appendicular Survived b.i.d, MMF 1 g b.i.d. osteomyelitis, soft tissue 28 Lewicky 36 Presumed Prednisone 15 mg daily Prednis N Y Axial Survived(50) sarcoidosis one d/c osteomyelitis, soft tissue (2 or more locations) 29 Miller (51) 61 Lung transplant Methylprednisone, azathioprine, and NR NR Y Soft tissue (2 or Died cyclosporine/ dose NR more locations) 30 Kuberski 57 Presumed Prednisone/ dose NR NR NR Y Axial Survived(52) costochondritis osteomyelitis 31 Antony 75 Unrelenting Prednisone taper over several weeks Prednis N Y Axial Survived(53) exophthalmos starting at 60 mg daily one d/c osteomyelitis 32 Wright (54) 46 Liver transplant Regimen and dose NR NR NR Y Axial Died osteomyelitis, CNS abscess, soft tissue (2 or more locations) 33 Wright (54) 28 Kidney transplant Regimen and dose NR NR NR Y Axial Died osteomyelitis, CNS abscess, soft tissue (2 or more locations) 34 Yorgin (55) 13 Lupus nephritis Pulse cyclophosphamide/ 500 mg/m2, NR NR Y CNS abscess, Died daily steroids/ dose NR lymphadenitis, soft tissue (2 or more locations)10 35 Fishco (56) 40 Sarcoidosis Prednisone, 10 mg and 20 mg on NR NR N Appendicular Survived alternate days osteomyelitis36 Erly (57) 74 Waldenström's Steroid therapy for 2 years and NR NR Y Axial Died macroglobulinemia intermittent chemotherapy for 5 years/ osteomyelitis, soft dose NR tissue (2 or more locations) 37 Smilack 72 Pulmonary Varying doses of prednisone for 5.5 Prednis N Y Axial Survived(58) sarcoidosis years/ doses NR one d/c osteomyelitis, cutaneous, soft tissue (2 or more locations) 38 Banuelos 50 Liver transplant Azathioprine, prednisone, tacrolimus/ NR NR Y Axial Survived(59) dose NR osteomyelitis, CNS abscess and meninges 39 Wagner 34 Non-Hodgkin's Two courses of ONCEP, one course of Immuno N Y Axial Died(60) lymphoma ESHAP/ doses NR suppres osteomyelitis sive therapy was delayed 40 Mischel 30 HIV No ART given CD4 N/A/ diagnosed Y CNS abscess and Died(61) count postmortem meninges80/ μL 41 Gold (62) 36 HIV Treated with zidovudine CD4 N/A Y Cutaneous, Died count lymphadenitis, 7/μL meninges, soft tissue (2 or more locations)11 Odio 12 42 Zar (63) 28 HIV No ART given CD4 N/A N Axial Survived count osteomyelitis, 576/μL blood, meninges, soft tissue 43 Dodd (64) 60 Liver transplant Prednisone and cyclosporine/ doses NR NR NR Y Soft tissue Died 44 Byrne (65) 57 HIV No ART given CD4 N/A Y Blood, meninges, Died of count soft tissue other 10/ μL cause 45 Prichard 28 HIV No ART given CD4 N/A Y Axial Died(66) count osteomyelitis, NR cutaneous 46 Vartivarian 29 Heart transplant Cyclosporine, 400 mg daily, rabbit Prednis Patient died <1 mo Y Axial Died(67) antithymocyte globulin, 500 mg one after infection osteomyelitis, intramuscular daily, and prednisone 60 was presentation; CM blood, cutaneous, mg daily. tapered diagnosed postmortem soft tissue (2 or to 5 more locations) mg/day 47 Ampel (68) 20 Kidney transplant Azathioprine 150 mg daily, prednisone Both Y but later relapsed Y Blood, soft tissue Died25 mg daily were reduced 48 Ampel (68) 83 Chronic lymphocytic Dexamethasone 24 mg daily NR NR Y Blood Died leukemia 49 Ampel (68) 6 Lymphoblastic Dexamethasone 3 mg daily NR NR Y Blood Died lymphoma 50 Ampel (68) 81 Chronic lymphocytic Prednisone 10 mg daily NR NR Y Blood, soft tissue Died leukemia 51 Ampel (68) 63 Bacterial Dexamethasone 16 mg daily NR NR Y Blood Died osteomyelitis 52 Ampel (68) 54 Breast carcinoma Prednisone 5 mg daily NR NR Y Blood, soft tissue Died 53 Ampel (68) 68 Large cell carcinoma Dexamethasone 16 mg daily NR NR Y Blood Died of lung; squamous cell carcinoma of the 12 hypopharynx 54 Ampel (68) 24 HIV ART NR CD4 NR Y Blood Survived count NR 55 Ampel (68) 62 Chronic lung disease; Prednisone 25 mg daily NR NR Y Blood DiedIdiopathic cardiomyopathy 56 Ampel (68) 46 Chronic lung disease Prednisone 70 mg daily NR NR Y Blood Survived 57 Ampel (68) 71 Glioblastoma Dexamethasone 4 mg t.i.d. NR NR Y Blood Died 58 Ampel (68) 58 HIV ART NR CD4 N/A Y Blood Died count NR 59 Ampel (68) 32 HIV No ART given CD4 N/A Y Blood Died count NR 60 Wolf (69) 36 HIV No ART given CD4 N/A N Cutaneous, Survived count lymphadenitis, 6.1 K soft tissue 61 Parker (70) 30 Lupus nephritis Prednisone 200 mg daily, Prednis Y Y Axial Survived cyclophosphamide 300 mg daily one osteomyelitis, soft was tissue tapered 62 Abrams 30 HIV No ART given CD4 N/A Y Axial Died(71) count osteomyelitis, 2.7 K blood, lymphadenitis, soft tissue (2 or more locations) 63 Kovacs 30 HIV No ART given CD4 N/A Y Lymphadenitis, Died of (72) count soft tissue other 2.9 K cause13 Odio 14 64 Howard 39 Kidney transplant Prednisone 40 mg daily, azathioprine NR NR, patient died 1 Y Soft tissue Died (73) 125 mg daily week after hospitalization for infection 65 Howard 32 Lupus nephritis Prednisone 5 mg daily NR NR Y Axial Survived(73) osteomyelitis, blood, meninges, soft tissue (2 or more locations) 66 Brewer 51 Heart transplant Azathioprine, methylprednisone, NR NR Y CNS abscess, Died(74) antilymphocyte globulin/ doses NR soft tissue (2 or more locations) 67 MacDonald 5.5 ALL Monthly doses of vincristine sulfate (1.5 All Y Y Cutaneous, Survived(75) mg intravenously), prednisone (40 immuno lymphadenitis mg/day for 5 days), weekly oral doses of suppres methotrexate (20 mg per dose), and sives daily doses of mercaptopurine (75 mg) were held 68 Allen (76) 66 Emphysema Prednisone/ 35 mg daily No Died three days after Y Soft tissue (2 or DiedCM diagnosed and more locations) antifungals given 69 Gardner 1 Rhinitis, stridor and Dexamethasone/ dose NR D/C Y Y Soft tissue Survived(77) cough unresponsive to antibiotics 70 Kaplan 20 Kidney transplant Prednisone 30 mg every other day, Both Y Y Cutaneous, Survived(78) azathioprine, 50 mg daily. were meninges, soft d/c tissue 71 Davis (79) 32 Presumed pulmonary Steroids/ dose NR D/C N Y Meninges Survived sarcoidosis14 72 Halpern 23 Sarcoidosis Steroids/ dose NR NR NR Y Axial Survived(80) osteomyelitis, lymphadenitis, soft tissue (2 or more locations) 73 Harvey 23 Lupus nephritis Prednisone 60 mg daily Tapere N N Axial Survived(81) d to osteomyelitis, soft12.5 tissue mg/day 74 Schroter 44 Kidney transplant Prednisone 200 mg daily, azathioprine N CM Diagnosed Y Lymphadenitis, Died(82) 150 daily postmortem soft tissue (2 or more locations) 75 Lee (83) 48 Kidney transplant Prednisone 20 mg daily; azathioprine NR NA Y Cutaneous Survived150 mg76 Krulig (84) 57 Pemphigus vulgaris Betamethasone 12 mg daily, N CM Diagnosed Y Axial Died azathioprine 200 mg daily postmortem osteomyelitis, lymphadenitis, soft tissue (2 or more locations) 77 Deresinski 32 Hodgkin’s lymphoma Prednisone 40 mg daily NR CM diagnosed Y Axial Died(85) postmortem osteomyelitis, lymphadenitis, meninges, soft tissue (2 or more locations) 78 Deresinski 16 Hodgkin’s lymphoma MOPP NR Patient died 9 days Y Axial Died(85) after nodules appeared osteomyelitis, lymphadenitis, soft tissue (2 or 15 Odio 16 more locations)79 Deresinski 37 Hodgkin’s lymphoma MOP MOP N; died 6 months after N Meninges Died(85) D/C CM diagnosis despite antifungals16 Supp Table 3. Demographic information of patients with exogenous immune suppression and disseminated coccidioidomycosis*Other: Native American (2), Not reported (19)Total Survived Died Death from other cause Total, n (%) 79 35 (44) 39 (49) 5 (6) Age, years, median (IQR) 44 (28 – 62) 36 (23 – 57) 46 (30 – 63) 56 (36 – 65) Gender, Male, n (%) 59 (75) 23 (66) 31 (79) 5 (100) Race, n (%) Black 9 (11) 6 (17) 3 (8) 0 (0) White 29 (37) 13 (37) 16 (41) 0 (0) Asian 3 (4) 2 (6) 1 (3) 0 (0) Latino 16 (20) 3 (9) 11 (28) 2 (40) *Other 22 (28) 11 (31) 8 (21) 3 (60) Immune suppression Cause, n(%) Transplant regimen 24 (30) 9 (26) 13 (33) 2 (40) Isolated steroid therapy 29 (37) 16 (46) 12 (31) 1 (20) Cancer chemotherapy 8 (10) 4 (11) 4 (10) 0 (0) HIV 12 (15) 4 (11) 6 (15) 2 (40) Regimens for autoimmune 6 (8) 2 (6) 4 (10) 0 (0) disease Site of dissemination, n (%) Pulmonary disease 68 (86) 26 (74) 37 (95) 5 (100) Osteomyelitis 29 (37) 16 (46) 12 (31) 1 (20) Axial 23 (29) 11 (31) 11 (28) 1 (20) Appendicular 6 (8) 5 (14) 1 (3) 0 (0) CNS Infection 20 (25) 8 (23) 11 (28) 1 (20) Meningitis 12 (15) 7 (20) 4 (10) 1 (20) Abscess 5 (6) 0 (0) 5 (13) 0 (0) Meningitis and 3 (4) 1 (3) 2 (5) 0 (0) abscess Lymphadenitis 12 (15) 3 (9) 7 (18) 2 (40) Cutaneous 17 (22) 13 (37) 4 (11) 0 (0) Soft tissue 44 (56) 16 (46) 23 (59) 5 (100) 2 or more locations 22 (28) 4 (11) 17 (44) 1 (20) Blood 29 (37) 8 (23) 21 (54) 0 (0) Year Published, n (%) 2000 - 2013 35 (44) 20 (57) 12 (31) 3 (60) 1990 - 1999 8 (10) 3 (9) 5 (13) 0 (0) 1980 - 1989 27 (34) 8 (23) 17 (44) 2 (40) 1970 - 1979 9 (11) 4 (11) 5 (13) 0 (0) 17 Odio 18Supp. Table 4. Location of coccidioidomycosis dissemination by racial group in patients with exogenous immunosuppression. *Other: Native American (2), Not reported (19)Total, n (%) Black White Latino Asian *OtherTotal, n 79 9 29 16 3 22 Pulmonary disease 68 (86) 9 (100) 25 (86) 14 (88) 2 (67) 18 (82) Osteomyelitis 29 (37) 4 (44) 7 (24) 7 (44) 1 (33) 10 (45) Axial 23 (29) 4 (44) 6 (21) 7 (44) 1 (33) 5 (23) Appendicular 6 (8) 0 (0) 1 (3) 0 (0) 0 (0) 5 (23) CNS 20 (25) 3 (33) 6 (21) 4 (25) 2 (67) 5 (23) Meningitis 12 (15) 2 (22) 3 (10) 2 (13) 2 (67) 3 (14) Abscess 5 (6) 1 (11) 3 (10) 0 (0) 0 (0) 1 (5) Meningitis and 3 (4) 0 (0) 0 (0) 2 (13) 0 (0) 1 (5) abscess Lymphadenitis 12 (15) 1 (11) 4 (14) 5 (31) 0 (0) 2 (9) Cutaneous lesions 17 (22) 0 (0) 7 (24) 1 (6) 1 (33) 8 (36) Soft Tissue 44 (56) 4 (44) 15 (52) 10 (63) 0 (0) 15 (68) 18 2 or more locations 22 (28) 4 (44) 7 (24) 5 (31) 0 (0) 6 (27) Blood 29 (37) 3 (33) 17 (59) 5 (31) 1 (33) 3 (14)19 Odio 20 Supp. Table 5. Patients with multi-site disseminated coccidioidomycosis (MDCM)As: Asian, B: Black, L: Latino/a, Nat Am: Native American, NR: Not reported, W: White A: Amphotericin, C: Caspofungin, D: Difulcan, F: Fluconazole, I: Itraconazole, K: Ketoconazole, LA: Liposomal amphotericin, M: Miconazole, P: Posaconazole, V: VoriconazoleCase First Author Age Rac Sex PMH Pulmonary disease Location Antifungal Surgery Abscess/ No. of Final No. (Y) e of s Used Fluid Relapses Outcome Dissemina Drainage tion 1 Fierer (86) 52 B M Other N Cutaneous LA, F, P N N 0 Survived illness , soft tissue 2 Duplessis (87) 30 B M Other Y Axial/ LA, P, IFN- N N 0 Survived infection appendicul γ ar osteomyeli tis 3 Duplessis (87) 23 B M None N Axial LA, I, P, Y N 0 Survived osteomyeli IFN- γ tis (multiple locations) 4 Silva- 20 L M Other Y Cutaneous LA, F N N 1 Death Hernandez infection , soft from other (88) tissue causes 5 Keckich (39) 70 W M Other Y Blood, F N N 0 Survived illness Meninges, soft tissue 6 Keckich (39) 63 B M Other Y Blood, Soft F N N 0 Survived illness tissue (2 or more locations) 7 Keckich (39) 47 W M Other Y Blood 20 illness 8 Kwok (89) 50 NR M None Y Cutaneous F N N 0 Survived, lymphaden itis 9 Kwok (89) 42 NR M Other N Axial A, F N N 0 Death infection/ osteomyeli from other Other tis, soft causes illness tissue 10 Wilde (90) 42 B F Other Y Axial A, F N N 1 Death illness osteomyeli from other tis, soft causes tissue 11 Nolt (91) 0 NR M Other Y CNS F N N 0 Survived infection abscess, lymphaden itis 12 Crum- 19 L F None Y Lymphade LA, F Y Y 0 SurvivedCianflone (92) nitis, soft tissue 13 Crum- 31 B M Other Y Cutaneous LA, F Y Y 0 SurvivedCianflone (92) illness , lymphaden itis, soft tissue 14 Crum- 65 As M Other Y Appendicul LA, F N Y 0 SurvivedCianflone (92) illness ar osteomyeli tis, soft tissue 15 Rosendahl (93) 32 W M None Y CNS F N N 1 Survived21 Odio 22 abscess, cutaneous 16 Crum (94) 59 L F Other Y Axial LA, I N N 0 Survived illness osteomyeli tis, cutaneous, lymphaden itis 17 Anstead (27) 17 B F None Y Osteomyeli LA, F, P, Y Y 1 Died tis V, C, IFN-γ unspecifie d location, cutaneous, soft tissue 18 Anstead (27) 20 B M None Y Axial and A, LA, F, I, N N 1 Survived appendicul K, P ar osteomyeli tis, cutaneous 19 La Via (95) 10 L M Other Y Meninges, A, LA, F, I Y N 1 Survived illness soft tissue (2 or more locations) 20 Biller (96) 24 B F None Y Axial LA, F, V N Y 0 Survived osteomyeli tis, CNS abscess, lymphaden itis 22 21 Prabhu (97) 31 B M None Y Axial and A, LA, F, I, N N 1 Survived appendicul V, C ar osteomyeli tis, soft tissue 22 Arnold (98) 17 As F None Y Axial and A, F N N 0 Survived appendicul ar osteomyeli tis, cutaneous 23 Arnold (98) 29 As M None Y Axial A, F N N 0 NR osteomyeli tis, cutaneous, soft tissue 24 Baddley (99) 28 B F None N Axial A, LA, F N Y 0 Survived osteomyeli tis, cutaneous, soft tissue 25 Crum and 20 L M None N Axial and A, I N N 0 SurvivedLederman (29) appendicul ar osteomyeli tis, soft tissue 26 Crum and 21 B M None Y Axial A, LA, I N N 1 SurvivedLederman (29) osteomyeli 23 Odio 24 tis, soft tissue 27 Crum and 22 B M None Y Axial and A, I N N 0 SurvivedLederman (29) appendicul ar osteomyeli tis, cutaneous 28 Crum and 59 L F None Y Axial A, F, I N N 0 SurvivedLederman (29) osteomyeli tis, cutaneous 29 Crum and 25 L F None Y Appendicul A, F N N 1 SurvivedLederman (29) ar osteomyeli tis, cutaneous, lymphaden itis 30 Crum and 23 B M None Y Axial A, I N N 0 SurvivedLederman (29) osteomyeli tis, cutaneous 31 Crum and 29 As M None N Axial A, I N N 1 SurvivedLederman (29) osteomyeli tis, cutaneous, lymphaden itis 32 Crum and 36 B M None N Axial and A, F N N 0 Survived24 Lederman (29) appendicul ar osteomyeli tis 33 Crum and 49 As F None Y Cutaneous F N N 1 SurvivedLederman (29) , lymphaden itis 34 Crum and 52 W M None Y Axial and A, F, I N N 0 SurvivedLederman (29) appendicul ar osteomyeli tis , cutaneous 35 Crum and 35 L M None N Axial F N N 0 SurvivedLederman (29) osteomyeli tis, cutaneous, meninges 36 Crum and 42 As M Other Y Axial A, F, I N N 0 SurvivedLederman (29) illness osteomyeli tis, cutaneous, soft tissue 37 Crum and 40 As F None Y Lymphade F N N 0 SurvivedLederman (29) nitis, soft tissue 38 Crum and 45 As M None N Cutaneous A, F N N 2 SurvivedLederman (29) , meninges and CNS 25 Odio 26 abscess, lymphaden itis 39 Crum and 52 As M None N Cutaneous A, F Y Y 2 SurvivedLederman (29) , meninges 40 Danaher (100) 20 B M NR Y Axial and A, LA, F, P Y N 3 Survived appendicul ar osteomyeli tis, cutaneous, soft tissue 41 Crum (94) 22 B M None Y Axial and LA N N 0 Survived appendicul ar osteomyeli tis, cutaneous 42 Crum (94) 59 L F None Y Axial A, I N N 0 Survived osteomyeli tis, cutaneous 43 Crum (94) 19 As M None N Axial and A N Y 0 Survived appendicul ar osteomyeli tis, soft tissue 44 Crum (94) 21 B M None Y Axial A, I Y N N/A Survived osteomyeli26 tis, soft tissue (2 or more locations) 45 Crum (94) 21 B M NR Y Axial A, I Y N N/A Survived osteomyeli tis, lymphaden itis, soft tissue 46 Holley (101) 32 NR M NR N Axial A, I N N 0 Survived osteomyeli tis, soft tissue 47 Erly (57) 33 NR M None N Meninges F N N 1 Died and CNS abscess, soft tissue 48 Polesky (102) 41 B F None N Lymphade A, F, I N N 4 Survived nitis, soft tissue 49 Polesky (102) 48 Paki M Other Y Cutaneous A, F, I N N 1 Survived stan illness , i lymphaden itis, soft tissue 50 Koehler (103) 32 As M None Y Osteomyeli A, LA, F, I, N N 0 Survived tis K(unspecifie d location),27 Odio 28 cutaneous, lymphaden itis, soft tissue 51 Cunningham 32 B M None Y Axial and A, F N N N/A NR(28) appendicul ar osteomyeli tis, cutaneous, soft tissue 52 Westphal (104) 25 NR M NR N Axial A, F N N 2 Died osteomyeli tis, cutaneous 53 Herron (105) 34 B M NR N Axial A Y Y 0 Survived osteomyeli tis, soft tissue 54 Woo (106) 63 NR F None Y Cutaneous A N N 0 Died, lymphaden itis, soft tissue (2 or more locations) 55 Banuelos (59) 45 L M Other Y Osteomyeli A Y N 1 Died illness tis (unspecifie d location), 28 meninges and CNS abscess, soft tissue 56 Banuelos (59) 21 W M Other Y Axial A, F Y N 0 Survived illness osteomyeli tis, CNS abscess, soft tissue 57 Banuelos (59) 63 W M Other Y Lymphade A, F N N 1 Died illness nitis, meninges and CNS abscess, soft tissue (2 or more locations) 58 Olson (107) 27 B M Other N Axial A N N 0 Survived infection osteomyeli tis, soft tissue (2 or more locations) 59 Olson (107) 27 As M NR Y Appendicul A, F N Y 1 Survived ar osteomyeli tis, cutaneous, lymphaden29 Odio 30 itis 60 Oudiz (108) 24 As M Other Y Lymphade None N Y 0 Died illness nitis, soft tissue (2 or more locations) 61 Hicks (109) 24 B M None Y Cutaneous A, K N N 0 Survived, lymphaden itis, soft tissue 62 Beard (110) 25 B M None Y Axial A, F N N 0 Survived osteomylei tis, cutaneous, soft tissue 63 Lopez (111) 70 NR M NR Y Lymphade A N N 0 Died nitis, soft tissue 64 Lopez (111) 65 NR M Other N Soft tissue None N N 0 Died illness (2 or more locations) 65 Schwartz (112) 71 W M Other Y Meninges, A, F, K N N 1 Survived illness soft tissue (2 or more locations) 66 Chen (113) 28 As M None Y Cutaneous F N N 1 Survived, lymphaden itis 67 Jitsukawa 39 As M Other Y Axial I, M N N 2 Survived30 (114) illness osteomyeli tis, cutaneous, soft tissue 68 Ampel (68) 19 W M None Y Blood, Soft A N N 0 Survived tissue (2 or more locations) 69 Ampel (68) 23 B M None N Blood, A N N 0 SurvivedCutaneous, soft tissue 70 Gillespie (115) 1 B M None N Axial and A, I, K Y N 0 Survived appendicul ar osteomyeli tis, soft tissue 71 Weisman (116) 21 W M None N Lymphade A, I, K Y Y 2 Survived nitis, soft tissue (2 or more locations) 72 Parker (70) 37 NR M NR Y Axial A N N 0 Survived osteomyeli tis, cutaneous, meninges 73 Howard (73) 19 W M None Y Blood, Soft A N N 0 Survived tissue (2 or31 Odio 32 more locations) 74 Meyer (117) 44 W M Other Y Cutaneous A Y Y 4 Died infection , meninges and CNS abscess, lymphaden itis, soft tissue (2 or more locations) 75 Burch (118) 35 B M None N Axial A N N 1 Death osteomyeli from other tis, causes cutaenous 76 Johnson (119) 39 NR F Other N Appendicul A N Y 0 Died illness ar osteomyeli tis, meninges and CNS abscess, soft tissue 77 Blumenkranz 57 W M None Y Meninges, A, K, M N N 0 Survived(120) soft tissue 78 Blumenkranz 48 L M Other Y Meninges, A, K N N 0 Death (120) infection/ soft tissue from other Other causes illness 79 Blumenkranz 40 Nat M NR Y Meninges, A, M N Y 2 Survived32 (120) Am soft tissue 80 McGahan 26 B M Other N Axial A N N 0 Survived(121) illness osteomyeli tis, cutaneous 81 McGahan 21 B M NR Y Axial and A, M N N 1 Survived(121) appendicul ar osteomyeli tis, lymphaden itis, soft tissue 82 McGahan 20 L M NR N Axial and A N N 0 NR(121) appendicul ar osteomyeli tis, cutaneous, lymphaden itis soft tissue 83 McGahan 62 B M NR N Axial A N N 0 Died(121) osteomyeli tis, soft tissue 84 Graybill (122) 73 NR F Other Y Axial A, K, M N N 2 Death illness osteomyeli from other tis, causes cutaneous, 33 Odio 34 soft tissue 85 Graybill (122) 28 L M NR Y Axial and A, K, M N N 4 Survived appendicul ar osteomyeli tis, lymphaden itis, meninges, soft tissue 86 Goldstein (123) 35 W M Other Y Lymphade A N N 0 Died illness nitis, meninges, soft tissue (2 or more locations) 87 Meyer (124) 51 B M NR N Axial and A, M N Y 2 Survived appendicul ar osteomyeli tis, cutaneous, soft tissue (2 or more locations) 88 Meyer (124) 54 B M NR Y Axial and A, M N Y 1 Survived appendicul ar osteomyeli34 tis, soft tissue 89 Meyer (124) 52 W M Other Y Axial and A, M Y Y 0 Death illness appendicul from other ar causes osteomyeli tis, cutaneous, lymphaden itis, meninges and CNS abscess, soft tissue (2 or more locations) 90 Meyer (124) 54 B M NR Y Axial A, M N N 3 Died osteomyeli tis, cutaneous, lymphaden itis, meninges, soft tissue 91 Meyer (124) 34 B M None Y Meninges, A, M Y Y 0 Died soft tissue 92 Danoff (125) 40 NR M Other Y Cutaneous A, M Y N 5 Died illness , lymphaden35 Odio 36 itis, meninges 93 Harvey (81) 43 W M NR Y Lymphade A Y Y 2 Survived nitis, soft tissue 94 Lee (83) 31 NR M NR Y Axial and A, M N N 0 Died appendicul ar osteomyeli tis, meninges 95 Thadepalli 26 B M NR Y Osteomyeli A Y N 2 Survived(126) tis (unspecifie d location), meninges, soft tissue 96 Armbuster 33 W M NR Y Axial and A, M N N 0 Survived(127) appendicul ar osteomyeli tis, cutaneous, meninges 97 Armbuster 30 B M NR Y Axial and A N N 0 Survived(127) appendicul ar osteomyeli tis, cutaneous, 36 lymphaden itis 98 Kaplan (128) 36 W M Other N Axial A N N 1 Survived infection osteomyeli tis, cutaneous, lymphaden itis 99 Sung (129) 50 B M None N Axial A, M N Y 1 Survived osteomyeli tis, cutaneous, soft tissue 100 Winter (130) 27 B M NR Y Axial and A Y N 1 Survived appendicul ar osteomyeli tis, meninges, soft tissue37 Odio 38Supp. Table 6. Demographic information of patients with multi-site disseminated coccidioidomycosis (MDCM)*Other: Native American (1), Pakistani (1), Not reported (14)$Time to outcome is days to final follow-up with patients in published reports. It typically represented time from presentation of disseminated coccidioidomycosis symptoms to cure, death, follow-up on long-term antifungals, or termination of antifungal therapy.Total Survived Died Death from other Outcome Not cause Reported Total, n 100 72 18 7 3 Age, years, median (IQR) 33 (23 – 48) 30 (22 - 45) 42 (33 – 62) 42 (35 - 52) 29 (20 – 32) Gender, Male, n (%) 84 (84) 61 (85) 15 (83) 5 (71) 3 (100) Race, n (%) Black 39 (39) 32 (44) 4 (22) 2 (29) 1 (33) White 17 (17) 12 (17) 4 (22) 1 (14) 0 (0) Latino 13 (13) 9 (13) 1 (6) 2 (29) 1 (33) Asian 15 (15) 13 (18) 1 (6) 0 (0) 1 (33) *Other 16 (16) 6 (8) 8 (44) 2 (29) 0 (0) Location of Dissemination, n (%) Pulmonary disease 71 (71) 51 (71) 13 (72) 5 (71) 2 (67) Osteomyelitis 62 (62) 47 (65) 7 (39) 5 (71) 3 (100) Axial 31 (31) 23 (32) 3 (17) 4 (57) 1 (33) Appendicular 4 (4) 3 (4) 1 (6) 0 (0) 0 (0) Axial/ Appendicular 23 (23) 19 (26) 1 (6) 1 (14) 2 (67) Unspecified location 4 (4) 2 (3) 2 (11) 0 (0) 0 (0) Central Nervous System 29 (29) 17 (24) 10 (56) 2 (29) 0 (0) Meninges 18 (18) 12 (17) 5 (28) 1 (14) 0 (0) Brain abscess 4 (4) 4 (6) 0 (0) 0 (0) 0 (0) Meninges and 7 (7) 1 (1) 5 (28) 1 (14) 0 (0) abscess Lymphadenitis 34 (34) 24 (33) 8 (44) 1 (14) 1 (33) Cutaneous lesions 52 (52) 38 (53) 6 (33) 5 (71) 3 (100) Soft Tissue 66 (66) 43 (60) 14 (78) 6 (86) 3 (100) 2 or more tissues 15 (15) 8 (11) 6 (33) 1 (14) 0 (0) Blood 6 (6) 5 (7) 1 (6) 0 (0) 0 (0) Number of antifungals given, 2 (1 - 2) 2 (1 - 3) 1 (1 - 2) 2 (2 - 2) 2 (1 - 2) median (IQR) Given 1 yr or more of medication, n 51 (51) 42 (58) 6 (33) 3 (43) 0 (0)(%) Surgery, n (%) 21 (21) 15 (21) 5 (28) 1 (14) 0 (0) Abscess/ fluid drainage, n (%) 21 (21) 15 (21) 5 (28) 1 (14) 0 (0) Relapse, n (%) 40 (41) 28 (40) 8 (44) 4 (57) 0 (0) Time to outcome (days)$, median 365 (188 – 730) 365 (270 - 730) 296 (40 – 1186) 480 (210 – 545) N/A38 (IQR) Past medical history, n (%) No significant history 45 (45) 38 (53) 4 (22) 1 (14) 2 (66) Other Infection 6 (6) 4 (6) 1 (6) 1 (14) 0 (0) Other Illness 24 (24) 13 (18) 8 (44) 3 (43) 0 (0) Other infection/ other 2 (2) 0 (0) 0 (0) 2 (29) 0 (0)Illness Not Reported 23 (23) 17 (24) 5 (28) 0 (0) 1 (33)Supp. Table 7: Location of coccidioidomycosis dissemination in each racial group in patients with multi-site disseminated coccidioidomycosis (MDCM)*Other: Native American (1), Pakistani (1), Not reported (14)Total, n (%) Black White Latino Asian *OtherTotal, n 100 39 17 13 15 16 Pulmonary disease 71 (71) 25 (64) 15 (88) 10 (77) 11 (73) 10 (63) Osteomyelitis 62 (62) 32 (82) 5 (29) 9 (69) 9 (60) 7 (44) Axial 31 (31) 16 (41) 2 (12) 4 (31) 4 (27) 5 (31) Appendicular 4 (4) 0 (0) 0 (0) 1 (8) 2 (13) 1 (6) Axial/ Appendicular 23 (23) 14 (36) 3 (18) 3 (23) 2 (13) 1 (6) Unspecified 4 (4) 2 (5) 0 (0) 1 (8) 1 (7) 0 (0) location Central Nervous System 29 (29) 5 (13) 10 (59) 5 (38) 2 (13) 7 (44) Meninges 18 (18) 4 (10) 5 (29) 4 (31) 1 (7) 4 (25) Brain abscess 4 (4) 1 (3) 2 (12) 0 (0) 0 (0) 1 (6) Meninges and 7 (7) 0 (0) 3 (18) 1 (8) 1 (7) 2 (13) abscess Lymphadenitis 34 (34) 8 (21) 7 (41) 5 (38) 8 (53) 6 (38) Cutaneous lesions 52 (52) 20 (51) 6 (35) 8 (62) 11 (73) 7 (44) Soft Tissue 66 (66) 28 (72) 12 (71) 8 (62) 8 (53) 10 (63) 2 or more tissues 15 (15) 3 (8) 8 (47) 1 (8) 1 (7) 2 (13) Blood 6 (6) 2 (5) 4 (24) 0 (0) 0 (0) 0 (0)39 Odio 40Supp. Table 8. Patients with single site disseminated coccidioidomycosis (SDCM).Case First Author Age (Y) Race Gende Location of Dissemination Final Outcome No. r 1 Arora (131) 44 Black Male Axial osteomyelitis Survived 2 Kumar (132) 68 NR Male Appendicular osteomyelitis Survived 3 Newlon (133) 45 Black Male Cutaneous Survived 4 Evans (134) 36 Black Male Soft tissue Survived 5 Reach (135) 28 Black Female Axial osteomyelitis Survived 6 Gaidici (136) 37 NR Female Lymphadenitis Survived 7 Crum-Cianflone (92) 61 Asian Male Soft tissue Survived 8 Park (137) 31 Asian Male Cutaneous Survived 9 Hwang (138) 53 White Male Meningitis Survived 10 Chuang (139) 34 Asian Male Cutaneous Survived 11 Sohail (45) 61 NR Male Soft tissue Survived 12 Sohail (45) 82 NR Male Soft tissue Survived 13 Sohail (45) 84 NR Male Soft tissue Survived 14 Sohail (45) 68 NR Male Soft tissue Survived 15 Snyder (140) 66 White Female Meningitis Survived 16 Rodriguez (141) 56 Latino Male Soft tissue Survived 17 Crum (29) 25 Asian Male Cutaneous Survived 18 Crum (29) 17 Black Male Appendicular osteomyelitis Survived 19 Crum (29) 75 Black Male Axial osteomyelitis Survived 20 Crum (29) 21 Black Male Axial osteomyelitis Survived 21 Crum (29) 47 Asian Male Soft tissue Survived 22 Crum (29) 27 Black Male Cutaneous Survived 23 Crum (29) 66 Asian Female Meningitis Survived 24 Crum (29) 20 White Male Appendicular osteomyelitis Survived 25 Crum (29) 58 Asian Male Cutaneous Survived 26 Crum (29) 28 Black Male Cutaneous Survived 27 Crum (29) 23 Black Female Axial osteomyelitis Survived 28 Crum (29) 28 Black Male Axial osteomyelitis Survived 29 Crum (29) 32 White Male Cutaneous Survived 30 Crum (29) 54 Asian Male Soft tissue Survived 31 Crum (29) 56 Asian Female Appendicular osteomyelitis Survived 32 Crum (29) 66 White Female Appendicular osteomyelitis Survived 33 Crum (29) 40 Asian Male Meningitis Survived 34 Crum (29) 26 White Male Meningitis Survived 35 Crum (29) 43 Black Male Cutaneous Survived 36 Crum (29) 52 Asian Male Appendicular osteomyelitis Survived 37 Crum (29) 22 Asian Female Appendicular osteomyelitis Survived 38 Crum (29) 33 Black Male Axial osteomyelitis Survived 39 Crum (29) 25 Black Male Axial osteomyelitis Survived 40 Crum (29) 37 Black Male Appendicular osteomyelitis Survived 41 Crum (29) 46 Asian Male Appendicular osteomyelitis Survived 42 Crum (29) 22 NR Male Meningitis Survived 40 43 Crum (29) 25 Black Male Axial osteomyelitis Survived 44 Crum (29) 52 Asian Male Lymphadenitis Survived 45 Crum (29) 10 Black Female Soft tissue Survived 46 Crum (29) 51 Black Male Soft tissue Survived 47 Crum (29) 26 Asian Male Meningitis Survived 48 Crum (29) 35 Latino Male Cutaneous Survived 49 Crum (29) 1 Black Female Axial osteomyelitis Survived 50 Crum (29) 45 Asian Male Meningitis Survived 51 Crum (29) 67 Asian Male Appendicular osteomyelitis Survived 52 Crum (29) 27 White Male Appendicular osteomyelitis Survived 53 Crum (29) 20 Black Male Appendicular osteomyelitis Survived 54 Crum (29) 50 Black Male Appendicular osteomyelitis Survived 55 Crum (29) 40 NR Male Soft tissue Survived 56 Crum (29) 49 Native American Female Axial osteomyelitis Survived 57 Crum (29) 62 Black Male Soft tissue Survived 58 Crum (29) 35 White Female Meningitis Survived 59 Crum (29) 44 Asian Male Cutaneous Survived 60 Crum (29) 37 White Male Appendicular osteomyelitis Survived 61 Crum (29) 23 NR Male Axial osteomyelitis Survived 62 Werle (142) 50 Latino Male Axial osteomyelitis Survived 63 Reuss (143) 40 White Male Soft tissue Died of other causes 64 Truett (144) 65 Black Male Soft tissue Survived 65 Truett (144) 53 White Male Soft tissue Survived 66 Arnold (98) 11 Asian Female Soft tissue Survived 67 Crum (145) 21 Black Male Axial osteomyelitis Survived 68 Crum (145) 17 Black Male Appendicular osteomyelitis Survived 69 Crum (145) 24 Asian Male Cutaneous Survived Buchmiller-Crair 36 Black Male Soft tissue Survived70 (146) 71 Kim (147) 50 White Male Cutaneous Survived 72 Rance (148) 78 White Male Cutaneous Survived 73 Shibili (149) 23 Black Male Axial osteomyelitis Survived 74 Nakamura (150) 28 Asian Male Axial osteomyelitis Survived 75 Holley (101) 21 NR Female Appendicular osteomyelitis Survived 76 Holley (101) 27 NR Male Axial osteomyelitis Survived 77 Holley (101) 69 NR Female Appendicular osteomyelitis Survived 78 Holley (101) 54 NR Male Axial osteomyelitis Survived 79 Holley (101) 35 NR Male Appendicular osteomyelitis Survived 80 Holley (101) 20 NR Male Appendicular osteomyelitis Survived 81 Holley (101) 38 NR Male Appendicular osteomyelitis Survived 82 Holley (101) 32 NR Male Axial osteomyelitis Survived 83 Holley (101) 25 NR Male Appendicular osteomyelitis Survived 84 Holley (101) 30 NR Female Axial osteomyelitis Died of other causes 85 Holley (101) 29 NR Male Axial osteomyelitis Survived 86 Robertson (151) 48 Black Male Soft tissue Survived 87 Faul (152) 20 NR Male Soft tissue Survived 88 Olivere (153) 35 White Male Soft tissue Survived 89 Smilack (58) 78 NR Male Soft tissue Survived 90 Herron (105) 27 White Male Axial osteomyelitis Survived 91 Herron (105) 45 Black Male Axial osteomyelitis Survived 92 Herron (105) 51 White Female Axial osteomyelitis Survived 93 Herron (105) 76 White Male Axial osteomyelitis Survived 94 Herron (105) 35 Black Male Axial osteomyelitis Survived 41 Odio 42 95 Herron (105) 31 Black Male Axial osteomyelitis Survived 96 Herron (105) 63 White Male Axial osteomyelitis Survived 97 Herron (105) 27 Black Male Axial osteomyelitis Survived 98 Herron (105) 50 Black Male Axial osteomyelitis Survived 99 Herron (105) 62 Native American Male Axial osteomyelitis Survived 100 Herron (105) 23 Black Male Axial osteomyelitis Survived 101 Herron (105) 55 Black Male Axial osteomyelitis Survived 102 Herron (105) 21 Black Male Axial osteomyelitis Survived 103 Banuelos (59) 36 Latino Male Meningitis Survived 104 Banuelos (59) 42 Asian Male Meningitis Survived 105 Low (154) 4 NR Female Axial osteomyelitis Survived 106 Olson (107) 24 Black Male Axial osteomyelitis Survived 107 Cardone (155) 27 Latino Male Cutaneous Survived 108 Cardone (155) 53 White Female Cutaneous Survived 109 Harley (156) 23 Black Male Cutaneous Survived 110 Bickel (157) 0 Latino Male Appendicular osteomyelitis Survived 111 Kohn (158) 33 White Male Meningitis Survived 112 Sherman (159) 22 Black Female Axial osteomyelitis Died of other causes 113 Boyle (160) 40 White Female Lymphadenitis Survived 114 Sprinkle (161) 60 Latino Male Appendicular osteomyelitis Survived 115 Kuntze (162) 34 White Male Soft tissue Survived 116 Dudley (163) 21 NR Female Soft tissue Survived 117 Dudley (163) 13 NR Female Soft tissue Survived 118 Golden (164) 0 Latino Male Soft tissue Survived 119 Dickinson (165) 34 Latino Male Cutaneous Survived 120 Moreno (166) 22 White Male Cutaneous Survived 121 Schwartz (167) 83 Black Male Cutaneous Survived 122 Davidson (168) 66 NR Male Soft tissue Survived 123 Parker (169) 25 White Female Soft tissue Survived 124 Blumenkranz (120) 24 White Male Soft tissue Survived 125 Graybill (122) 24 Black Male Appendicular osteomyelitis Survived 126 Sung (170) 62 Latino Male Soft tissue Survived 127 Igo (171) 47 White Male Axial osteomyelitis Survived 128 Meyer (124) 45 Black Male Meningitis Survived 129 Meyer (124) 57 White Male Appendicular osteomyelitis Survived 130 Lee (83) 17 NR Male Lymphadenitis Died 131 Armbuster (127) 27 Latino Male Appendicular osteomyelitis Survived 132 Armbuster (127) 41 White Male Appendicular osteomyelitis Survived 133 Armbuster (127) 61 Asian Male Appendicular osteomyelitis Survived 134 Turner (172) 37 Black Male Soft tissue Survived 135 Ward (173) 0 Latino Male Soft tissue Survived 136 Winter (130) 49 Asian Male Appendicular osteomyelitis Survived 137 Winter (130) 22 White Male Appendicular osteomyelitis Survived 138 Winter (130) 2 NR Male Appendicular osteomyelitis Survived 139 Zeller (174) 43 Black Male Cutaneous Survived42 Supp. Table 9. Demographic information of patients with single site disseminated coccidioidomycosis (SDCM).*Other: Not reported (28), Native American (2)Total Survived Died Death from other cause Total, n (%) 139 135 (97) 1 (1) 3 (2) Age, years, median (IQR) 36 (24 – 52) 36 (25 – 53) 17 30 (22 – 40) Gender, Male, n (%) 115 (83) 113 (84) 1 (100) 1 (33) Race, n (%) Black 44 (32) 43 (32) 0 (0) 1 (33) White 29 (21) 28 (21) 0 (0) 1 (33) Asian 24 (17) 24 (18) 0 (0) 0 (0) Latino 12 (9) 12 (9) 0 (0) 0 (0) Other* 30 (22) 28 (21) 1 (100) 1 (33) Site of dissemination, n (%) Osteomyelitis 69 (50) 67 (50) 0(0) 2 (67) Axial 38 (27) 36 (27) 0 (0) 2 (67) Appendicular 31 (22) 31 (23) 0 (0) 0 (0) 43 Odio 44 Meningitis 13 (9) 13 (10) 0 (0) 0 (0) Lymphadenitis 4 (3) 3 (2) 1 (100) 0 (0) Cutaneous 21 (15) 21 (16) 0 (0) 0 (0) Soft tissue 32 (23) 31 (23) 0 (0) 1 (33) Year Published, n (%) 2000 - 2012 85 (61) 83 (61) 0 (0) 2 (67) 1990 - 1999 28 (20) 27 (20) 0 (0) 1 (33) 1980 - 1989 12 (9) 12 (9) 0 (0) 0 (0) 1970 - 1979 14 (10) 13 (10) 1 (100) 0 (0)Supp. Table 10. Location of coccidioidomycosis dissemination by racial group in patients with single-site disseminated coccidioidomycosis (SDCM). *Other: Native American (2), Not reported (28)Total, n (%) Black White Latino Asian *OtherTotal, n 139 44 29 12 24 30 Osteomyelitis 69 (50) 28 (64) 12 (41) 4 (33) 8 (33) 17 (57) Axial 38 (28) 22 (50) 5 (17) 1 (8) 1 (4) 9 (30) Appendicular 31 (22) 6 (14) 7 (24) 3 (25) 7 (29) 8 (27) Meningitis 13 (9) 1 (2) 5 (17) 1 (8) 5 (21) 1 (3) Lymphadenitis 4 (3) 0 (0) 1 (3) 0 (0) 1 (4) 2 (6) Cutaneous lesions 21 (15) 7 (16) 5 (17) 3 (25) 6 (25) 0 (0) Soft Tissue 32 (23) 8 (18) 6 (21) 4 (33) 4 (17) 10 (33)44 References1. MENDENHALL JC, BLACK WC, POTTZ GE. Progressive (disseminated) coccidioidomycosis during pregnancy. Rocky Mt Med J. 1948;45(6):472–6. 2. SMALE LE, BIRSNER JW. Maternal deaths from coccidioidomycosis. J Am Med Assoc. 1949;140(14):1152–4. 3. Conan J, Hyman GA. Disseminated coccidioidomycosis. Treatment with protoanemonin. Am J Med. 1950;9(3):408–13. 4. J.E. 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