Coccidioidomycosis symptoms and treatment
What is Coccidioidomycosis
An illness resulting from INFECTION with the spores of the fungus Coccidioides immitis, which occurs naturally in the soil in desert environments, inhaled into the LUNGS. Coccidioidomycosis affects the respiratory tract, primarily the lungs. About half of people infected with Coccidioides immitis do not become ill. The IMMUNE SYSTEM can successfully neutralize small numbers of Coccidioides immitis spores before they cause illness, though the person will test positive for infection. Exposure to high numbers of spores is more likely to result in illness. Among those who develop symptoms of coccidioidomycosis, commonly called valley FEVER, illness may be acute, chronic, or disseminated. In people who are IMMUNOCOMPROMISED, coccidioid omycosis may occur as an OPPORTUNISTIC INFECTION.
Symptoms of Coccidioidomycosis and Diagnostic Path
The most common form of coccidioidomycosis is acute, in which symptoms develop within four weeks of exposure. Symptoms include
- nonproductive (dry) COUGH and CHEST PAIN
- FEVER
- fatigue
- chills and night sweats
- diminished APPETITE and weight loss
- HEADACHE
- MUSCLE and JOINT PAIN
- RASH
- LYMPHADENOPATHY (swollen LYMPH nodes)
The diagnostic path includes chest X-RAY and coccidioidin SKIN test. The skin test is positive 21 days after exposure. BLOOD tests may also show elevated antibodies.
Coccidioidomycosis: Treatment Options and Outlook
Though the infection is self-limiting and resolves within three to six months without treatment in most people, doctors often prescribe ANTIFUNGAL MEDICATIONS to eradicate the infection more quickly and reduce the likelihood for complications, which may include MENINGITIS. Most people recover without residual effects. Some people develop chronic infection, in which symptoms recur. About 1 percent of people develop disseminated disease (also called progressive), in which the infection enters the blood circulation and travels to other structures and organs. Extended, sometimes lifelong, treatment with antifungal medications is required for chronic and disseminated coccidioidomycosis. People who are immunocompromised, take IMMUNOSUPPRESSIVE THERAPY, or are of Filipino or African American heritage have especially high risk for disseminated disease.
| ANTIFUNGAL MEDICATIONS TO TREAT COCCIDIOIDOMYCOSIS | |
|---|---|
| amphotericin B | fluconazole |
| itraconazole | ketoconazole |
Risk Factors and Preventive Measures Against Coccidioidomycosis
The primary risk factor for coccidioidomycosis is exposure to soil, especially dust, containing C. immitis spores. Public health officials often note spikes in reported infections after desert dust storms. Farm and ranch workers, construction workers, and archaeologists have increased risk for infection through continued exposure to soil and dust.
See also ASTHMA; BRONCHITIS; HISTOPLASMOSIS; PLEURAL EFFUSION; PNEUMONIA.
