Gender and Ancestry Distribution in Disseminated Coccidioidomycosis
The available evidence does not provide specific percentage breakdowns for gender or ancestry distribution among patients with disseminated coccidioidomycosis, but identifies male sex and African or Filipino ancestry as recognized risk factors for dissemination.
Risk Factor Profile for Dissemination
Male sex is identified as a risk factor for disseminated coccidioidomycosis, though the magnitude of increased risk is modest and does not warrant separate management protocols. 1
Ancestry-Related Risk
- African and Filipino ancestry confer higher risk for disseminated disease 1, 2
- The IDSA guidelines note that while ancestry is "thought to be significant," it carries "only modest" influence on management decisions and does not warrant separate treatment algorithms 1
- One recent case report documented severe disseminated musculoskeletal disease in a 33-year-old African American man who was immunocompetent 3
Gender Distribution
- Male sex increases dissemination risk, but the effect is less pronounced than immunosuppression 1
- The CDC/NIH guidelines specifically note that "Black and Filipino men appear to be at higher risk for disseminated disease" 1
- In immunosuppressed patients, the dissemination rate showed no gender-related difference, suggesting that immunosuppression overwhelms any gender-based risk 4
Baseline Dissemination Risk Context
- In immunocompetent patients without risk factors, disseminated disease occurs in less than 1% of infections 1
- Patients with specific gene mutations affecting interferon-γ and IL-12 pathways can have dissemination rates as high as 75% 1
- Immunosuppressed patients (high-dose corticosteroids, TNF inhibitors, organ transplant recipients) have dramatically elevated dissemination rates, with one study showing 50% dissemination in those receiving immunosuppressive therapy 4
Clinical Implications
The absence of specific percentage data for gender and ancestry distribution reflects that these factors are recognized as modest risk modifiers rather than major determinants of dissemination. 1 The IDSA explicitly states these factors "do not carry nearly the same degree of heightened risk" as immunosuppression and "only modestly should influence management decisions." 1
Common Pitfall to Avoid
Do not overweight male sex or ancestry when assessing dissemination risk—immunosuppression, pregnancy (especially third trimester), and specific genetic immune defects are far more powerful predictors 1, 2