Geographic distribution of endemic fungal infections among older persons, United States

Academic Article


  • To investigate the epidemiology and geographic distribution of histoplasmosis, coccidioidomycosis, and blastomycosis in older persons in the United States, we evaluated a random 5% sample of national Medicare data from 1999 through 2008. We calculated national, regional, and state-based incidence rates and determined 90-day postdiagnosis mortality rates. We identifi ed 776 cases (357 histoplasmosis, 345 coccidioidomycosis, 74 blastomycosis). Patient mean age was 75.7 years; 55% were male. Histoplasmosis and blastomycosis incidence was highest in the Midwest (6.1 and 1.0 cases/100,000 person-years, respectively); coccidioidomycosis incidence rate was highest in the West (15.2). On the basis of available data, for 86 (11.1%) cases, there was no patient exposure to a traditional disease-endemic area. Knowledge of areas where endemic mycosis incidence is increased may affect diagnostic or prevention measures for older adults at risk.
  • Digital Object Identifier (doi)

    Author List

  • Baddley JW; Winthrop KL; Patkar NM; Delzell E; Beukelman T; Xie F; Chen L; Curtis JR
  • Start Page

  • 1664
  • End Page

  • 1669
  • Volume

  • 17
  • Issue

  • 9