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Definition Return to top
Coccidioidomycosis is an infection caused by inhalation of spores of Coccidioides immitis, a fungus found in the soil in certain parts of the southwestern U.S., Mexico, and Central and South America.Causes, incidence, and risk factors Return to top
Coccidioides infection begins in the lungs, following inhalation of the spores. About 60% of infections resolve without ever causing symptoms and are only recognized by a positive coccidioidin skin test.
In the remaining 40% of infections, symptoms range from mild (cold-like or flu-like) to severe (pneumonia). (See coccidioidomycosis.) In less than 1% of infections, widespread disease occurs when the fungus spreads from the lungs through the blood stream to involve the skin, bones, joints, lymph nodes, and central nervous system or other organs.
Individuals of African or Philippine descent, and people with weakened immune systems due to AIDS, diabetes, or immunosuppressive medications, may develop more serious infections. Occasionally the acute infection may develop into a chronic pulmonary (lung) disease or can reactivate after a long latent period.
A history of travel to an endemic region is the key to suspecting coccidioidal infection. Arizona, California (especially San Joaquin Valley), and -- to a lesser extent -- western Texas, are endemic regions in the USA.
Symptoms Return to top
See also Skin lesion of coccidioidomycosis.
Signs and tests Return to top
Treatment Return to top
The acute disease is almost always benign and goes away without treatment. Bedrest and treatment of flu-like symptoms until fever disappears may be recommended.
In severe forms of the disease (disseminated coccidioidomycosis), antifungal treatment with amphotericin B, fluconazole, or itraconazole can be used. The best length of treatment with these medications has not been determined for this disease.
Expectations (prognosis) Return to top
The outlook in milder cases is usually good. Disseminated coccidioidomycosis can be serious, particularly in people with weakened immune systems.
Complications Return to top
Calling your health care provider Return to top
Prevention Return to top
Avoiding travel to regions where this fungus is found may prevent risk of developing this disorder. However, this is not practical or possible for many people. It may be prudent to try to avoid contact with soil in these regions if you have a weakened immune system due to HIV or other conditions.
Update Date: 8/6/2004 Updated by: Allen J. Blaivas, D.O., Division of Pulmonary, Critical Care, and Sleep Medicine, University Hospital, Newark, NJ. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |