Sertraline in Addition to Standard of Care Treatment for Coccidioidomycosis

• Severe coccidioidomycosis infection, manifest as by one of:

  • Coccidioidal meningitis;
  • Severe pulmonary infection requiring intensive care unit level of care;
  • Disseminated infection (in clinical opinion of the investigator); or
  • Clinical progression after >2 months of high dose fluconazole.
• Laboratory confirmation of Coccidioides infection by culture, histopathology, coccidioides polymerase chain reaction, positive complement fixation titer, or Coccidioides antigen

Exclusion Criteria:

• Age \< 18 years
• Cannot or unlikely to attend regular clinic visits
• Presence of jaundice or known liver cirrhosis

• Pregnancy

  • If there is a concern of pregnancy, a negative urine (or serum) pregnancy test before study entry is required.
  • Women of childbearing potential will have pregnancy test at enrollment and will be recommended to use contraception and referred to family planning services as necessary. (Refer to informed consent document.)
• Currently breastfeeding
• Active drug use (amphetamine or cocaine) or requirement for concomitant medications that raise the risk of serotonin syndrome
• Prolonged corrected QT interval or Left Bundle Branch Block on baseline electrocardiogram