Coccidioidomycosis

Coccidioidomycosis (also known as "California disease", "Desert rheumatism", "San Joaquin valley fever", and "Valley fever") is a fungal disease caused by Coccidioides immitis or C. posadasii. It is endemic in certain parts of Arizona, California, Nevada, New Mexico, Texas, Utah and northwestern Mexico.

Symptoms

The disease is usually mild, with flu-like symptoms and rashes. The Mayo Clinic estimates that half the population in some affected areas have suffered from the disease. On occasion, those particularly susceptible may develop a serious or even fatal illness from valley fever. Serious complications include severe pneumonia, lung nodules, and disseminated disease, where the fungus spreads throughout the body. The disseminated form of valley fever can devastate the body, causing skin ulcers, abscesses, bone lesions, severe joint pain, heart inflammation, urinary tract problems, meningitis, and often death. In order of decreasing risk, people of Filipino, African, Native American, Hispanic, and Asian descent are susceptible to the disseminated form of the disease. Men and pregnant women, and people with weakened immune systems (as from AIDS) are more susceptible than non-pregnant women.

Treatment

There are no published prospective studies that examine optimal antifungal therapy for coccidioidomycosis. Mild cases often do not require treatment. Oral Fluconazole and intravenous Amphotericin B are used in progressive or disseminated disease, or in which patients are immunocompromised. Alternatively, itraconazole or ketoconazole may be used. Posaconazole and voriconazole have also been used.