COCCIDIOIDOMYCOSIS
Coccidioidomycosis is a fungal infection caused by coccidioides.
- Coccidioidomycosis, also known as valley fever, is prevalent in certain parts of Arizona, California, Nevada, New Mexico, Texas, northern Mexico, and Utah.
- In the endemic areas of the United States, valley fever is a common cause of community-acquired pneumonia.
- Coccidiomycosis primarily affects the lungs but is not contagious.
- The condition can affect anyone, but it is most common among older adults, especially those 60 and older.
- Coccidioidomycosis may be acute, chronic, or disseminated.
- The initial, or acute form of the condition is usually mild and usually resolves on their own.
- If the acute stage of the infection doesn’t completely resolve, it may progress to a chronic form. The chronic form is most common in people with a weakened immune system.
- The most serious form of the condition occurs when the infection disseminates or spreads beyond the lungs to other parts of the body. It may spread to the liver, skin, bones, brain, heart, and the meninges (the membrane that protects the spinal cord and brain).
CAUSES
The condition is caused by two fungi, coccidioides immitis or coccidioides posadasii. These fungi are known to live and thrive in the soil in the desert region in the southern United States, parts of Mexico, and Central and South America.
These fungi grow as molds with long filaments that break off into airborne spores when the soil is disturbed by winds, construction, farming, and other activities, where people breathe them in.
Infections occur when the fungal spores are inhaled.
People who are at a higher risk of getting infected are:
- People with a weakened immune system such as seen in people with HIV/AIDS, who have had an organ transplant, are taking certain medications
- Pregnant women
- People with diabetes
- People of African and Filipino heritage
- Older adults
- People who have jobs that expose them to dust such as road, agricultural, construction workers, ranchers, archaeologists, and military personnel on field exercises.
SYMPTOMS
During the acute stage, symptoms may not be present. If they do, they may include:
- Chest pain
- A cough
- Fever
- A headache
- Fatigue
- Night Sweats
- Joint aches
- Red, spotty rash. The rash may appear on the lower legs but sometimes on the chest, arms and back.
During the chronic stage, and may include:
- low-grade fever
- chest pain
- a cough up mucus/sputum with blood in it
- weight loss
- nodules in the lungs
During the severe case-disseminated stage, symptoms depend on which part of the body is affected, and may include:
- Painful lesions in the skull, spine or other bones
- Swollen, painful joints, especially in knees or ankles
- Meningitis
- Ulcers, nodules and skin lesions.
DIAGNOSIS AND TREATMENT
To make a diagnosis, the doctor will depend on coccidioides organisms in tissue, blood or other body secretions. This may be achieved by:
Blood tests to check for antibodies against the fungus that causes the condition
Sputum culture to check the sample of the matter discharged while coughing for the presence of coccidiodes organisms.
An x-ray may also be carried out
It is important to note that symptoms of the condition are similar to those of other respiratory illnesses, so health care provider should consider testing for the condition in patients with flu-like symptoms who live or have traveled to areas where the fungus lives.
TREATMENT
The acute stage of the condition may require rest and fluids. The doctor will keep a close watch on how you are doing.
If you are at an increased risk of complications or your symptoms does not improve, anti-fungal medications such as fluconazole, itraconazole, amphoterin B may be prescribed.