Citations 3
A mixed methods survey of research education requirements for residents in internal medicine, neurology and transitional programs
O’Shea, Michael , Ashcherkin, Nikita, Biondi, Matt , Chaffin, Hally, Umar, Sarah B. , Delafield, Nathan, Chhabra, Nikita, Hoerth, Matthew T., Starling, Amaal J. , Valles, Brittane T., Wu, Christina, Taylor, Gretchen, Hawkins, Camille, Persons, Patress , Biondi, Matthew, Umar, Sarah, Hoerth, Matthew, Starling, Amaal, Valles, Brittane, Karikalan, Suganya Arunachalam , Biondi, Matt , Sharma, Umesh
Medical Education Online | April 24, 2025 | Volume: 30 | Issue: 1 | Pages: No page available
Outcomes of Coccidioides Seropositive Solid Organ Transplant Recipients After Self-discontinuation of Antifungal Prophylaxis: The EIA-IgM-only Conundrum
Biondi, Matt V., Shah, P. , Kodali, Lavanya , Chascsa, David M. , Blair, Janis E. , Biondi, Matt , Gupta, Simran , Shah, Priyal J , Chascsa, David M H, Buras, Matthew , Vikram, Holenarasipur R.
Transplantation | January 17, 2025 | Volume: 109 | Issue: 7 | Pages: 1251-1256
Background. Solid organ transplant recipients are at risk of severe coccidioidomycosis and are given prophylaxis to mitigate the risk. Patients with seropositive testing typically receive lifelong prophylaxis; currently, this prophylaxis strategy includes patients who are positive only for IgM by enzyme immunoassay (EIA-IgM-only), although this result may be falsely positive. Methods. We conducted a retrospective study at a large-volume transplant center in an endemic coccidioidomycosis region to compare outcomes of non–lung transplant recipients who were seropositive for Coccidioides but discontinued prophylaxis (case patients) to outcomes of patients who continued prophylaxis (controls). Results. No case or control patients developed active coccidioidomycosis during the follow-up period. Before transplant, 62 of 77 case patients (80.5%) had a single positive serologic test, of whom 27 of 62 were EIA-IgM-only positive (43.5%). In contrast, 57 of 77 controls (74.0%) had a single seropositive result (16/57 [28.1%] were EIA-IgM-only). The single EIA-IgM-only result was classified as falsely positive by infectious disease consultants in 20 of 43 patients (46.5%) compared with all other Coccidioides serologic results (13/111 [11.7%], P < 0.001). Lifetime antifungal prophylaxis was felt to be unnecessary for 28 of 43 patients (65.1%) who were EIA-IgM-only versus 31 of 111 patients (27.9%) with other serologic results (P < 0.001). Conclusions. For patients repeatedly positive for EIA-IgM-only and no evidence of seroconversion, compatible clinical illness, or radiographic findings, discontinuing antifungal prophylaxis may be reasonable after the first posttransplant year.
Improving Coccidioidomycosis Testing for Emergency Department Patients With Suspect Community-Acquired Pneumonia: Analysis of Provider Attitudes and the Effect of a Targeted Intervention
Cunningham, Cody A. , Brown, Ashlyn T, Ravi, Srekar , Bearss, Jeremiah J., O’Shea, Michael P, Elshaer, Amani , Biondi, Matt V., Seddighzadeh, Bobak, Elmasry, Sandra , Havanur, Amogh, Mahajan, Avanika , Savic, Juliana , Alozie, Nneoma U, Urumov, Andrej , Blair, Janis E. , Biondi, Matt , Ravi, Srekar N, Elshaer, Amani K, Elmasry, Sandra N, Rappaport, Douglas
Open Forum Infectious Diseases | August 12, 2024 | Volume: 11 | Issue: 8 | Pages: No page available
Abstract Coccidioidomycosis is a common cause of community-acquired pneumonia in endemic regions. Approximately 20 000 cases of coccidioidomycosis occur annually; however, this statistic is limited by a widespread lack of testing. Here, we analyze emergency medicine provider attitudes toward coccidioidal testing and assess the effect of an intervention to improve testing rates.