Summary about Disease
Coccidioidomycosis, often called Valley Fever or cocci, is an infection caused by the fungus Coccidioides immitis or *Coccidioides posadasii*. The fungus lives in the soil in certain parts of the southwestern United States, Mexico, and Central and South America. People can get infected by breathing in fungal spores that are stirred up into the air, often during construction, farming, or other activities that disrupt the soil. Most people who are exposed to the fungus don't get sick, but some develop symptoms.
Symptoms
Symptoms can vary widely. Many people have no symptoms at all. When symptoms do occur, they can include:
Fatigue
Cough
Fever
Shortness of breath
Headache
Night sweats
Muscle aches or joint pain
Rash (sometimes with painful bumps) In rare cases, the infection can spread from the lungs to other parts of the body, such as the skin, bones, brain, or other organs. This is called disseminated coccidioidomycosis.
Causes
Coccidioidomycosis is caused by inhaling Coccidioides fungal spores. These spores are present in the soil in certain geographic areas. Disturbance of the soil, such as through construction, farming, wind, or recreational activities, can release the spores into the air, where they can be inhaled.
Medicine Used
Antifungal medications are used to treat coccidioidomycosis. The specific medication and duration of treatment depend on the severity of the infection and whether it has spread beyond the lungs. Common medications include:
Fluconazole
Itraconazole
Voriconazole
Amphotericin B (used for severe cases)
Is Communicable
Coccidioidomycosis is not communicable from person to person or from animals to people. The infection is acquired only through inhaling spores from the environment.
Precautions
It is difficult to completely prevent exposure in areas where the fungus is prevalent. Precautions include:
Avoiding activities that disturb the soil, especially during dry and windy conditions.
Staying indoors during dust storms.
Using air filtration systems indoors.
Wetting down the soil before digging or other activities that might stir up dust.
Consider wearing a mask (such as an N95 respirator) when exposure to dust is unavoidable, especially for individuals with weakened immune systems.
How long does an outbreak last?
Outbreaks are not common in coccidioidomycosis. Single exposure or residing in an endemic area can cause the disease. The duration of symptoms varies depending on the severity of the infection and the individual's immune system. Some people recover without treatment, while others may require months or even years of antifungal medication. The "outbreak" is more related to an increase in cases due to increased dust exposure during dry periods or construction.
How is it diagnosed?
Diagnosis typically involves:
Medical History and Physical Exam: Review of symptoms and potential exposure.
Blood Tests: Tests to detect antibodies to the Coccidioides fungus.
Sputum Culture: If coughing up mucus, a sample can be cultured to identify the fungus.
Imaging Tests: Chest X-rays or CT scans to look for lung abnormalities.
Skin Test: A coccidioidin skin test can show if you have been exposed to the fungus, but can only determine past exposure.
Biopsy: In cases where the infection has spread, a biopsy of affected tissue may be performed.
Timeline of Symptoms
Incubation Period: Symptoms typically appear 1 to 3 weeks after exposure.
Initial Symptoms: Fatigue, cough, fever, headache, and muscle aches. These symptoms can be mild and may resemble a cold or the flu.
Progression: In some cases, symptoms worsen, leading to shortness of breath, chest pain, and rash.
Dissemination: In rare cases, the infection spreads to other parts of the body. This can occur weeks, months, or even years after the initial infection.
Important Considerations
People with weakened immune systems (e.g., those with HIV/AIDS, organ transplant recipients, those taking immunosuppressant medications) are at higher risk for developing severe or disseminated coccidioidomycosis.
Pregnant women are also at increased risk of complications.
The disease is more common in specific geographic areas. If you live in or travel to these areas, be aware of the risk.
Early diagnosis and treatment are important to prevent complications.
If you suspect you have coccidioidomycosis, consult a healthcare provider.