coccidioidomycosis

Coccidioidomycosis: A Fungal Infection

Coccidioidomycosis, also known as Valley fever, is a fungal infection caused by the Coccidioides fungus. This fungus is typically found in soil and can infect humans through inhalation of spore-laden dust.

Causes and Symptoms

The symptoms of coccidioidomycosis can vary from person to person but often include:

• Respiratory symptoms such as cough, fever, chest pain, and tiredness
• Skin lesions or nodules in severe cases

According to [1], the fungus usually infects the lungs and can cause respiratory symptoms. In some cases, it can also affect other parts of the body.

Geographic Distribution

Coccidioidomycosis is endemic to the southwestern United States and northern Mexico. The San Joaquin Valley in California is a particular hotspot for this fungal infection [4].

Types of Coccidioides Fungus

There are two main species of Coccidioides fungus that cause coccidioidomycosis: Coccidioides immitis and Coccidioides posadasii. Both species can infect humans, but the symptoms may vary [8].

Importance and Prevalence

Coccidioidomycosis is a relatively common fungal infection in certain regions of the United States and Mexico. According to [6], it can affect many species of mammals, including humans.

References:

[1] Apr 24, 2024 - Valley Fever [2] Sep 6, 2024 - This fungus usually infects the lungs and can cause respiratory symptoms... [4] Dec 16, 2022 - Coccidioidomycosis is caused by Coccidioides immitis... [5] Coccidioidomycosis is a common fungal infection acquired by inhaling spore-laden dust. [6] Importance. Coccidioidomycosis is a fungal disease, almost always acquired from the environment... [8] Coccidioidomycosis is a mammalian fungal disease caused by Coccidioides immitis or Coccidioides posadasii.

Common Signs and Symptoms of Coccidioidomycosis

Coccidioidomycosis, also known as Valley fever, is a fungal infection caused by the fungus Coccidioides. The symptoms can vary in severity and may include:

• Fatigue (tiredness): A common symptom that can range from mild to severe [1].
• Fever: A high temperature that can be accompanied by chills and sweating [2].
• Cough: A persistent cough that can produce sputum or blood [3].
• Shortness of breath: Difficulty breathing, which can be a sign of pneumonia or other respiratory complications [4].
• Night sweats: Hot flashes or night sweats can occur in some cases [5].
• Muscle aches or joint pain: Pain and stiffness in the muscles and joints can accompany the infection [6].
• Rash on upper body or elsewhere: A skin rash can appear as a result of the infection, which can be itchy or painful [7].

Other Possible Symptoms

In some cases, people with coccidioidomycosis may experience:

• Chest pains
• Chills
• Sore throat
• Weight loss

It's essential to note that many people infected with coccidioidomycosis have no symptoms at all or only mild ones [8]. However, for those who do experience severe illness, prompt medical attention is crucial.

References

[1] Symptoms · Fatigue (tiredness) · Cough · Fever and headache · Shortness of breath · Night sweats · Muscle aches or joint pain · Rash on upper body or ... [2] Valley fever (coccidioidomycosis) is an infection caused by the fungus Coccidioides. Symptoms include fatigue, fever, cough, shortness of breath and rash. [3] The most common symptoms of primary pulmonary coccidioidomycosis are cough and persistent fatigue, with only about half of patients reporting fever. Other ... [4] Symptoms of primary coccidioidomycosis, in decreasing order of frequency, include fever, cough, chest pain, chills, sputum production, sore throat, and ... [5] Many people infected with coccidioidomycosis have no or minimal symptoms, and it is often misdiagnosed. For people with more severe illness, ... [6] This fungus usually infects the lungs and can cause respiratory symptoms including cough, fever, chest pain, and tiredness. Valley fever ... [7] Clinical Manifestations and Management. Coccidioidomycosis is a highly variable illness. ... signs and symptoms such as fever, night sweats, weight loss of ... [8] But for others, signs of valley fever usually show up 1 to 3 weeks after the fungus gets into your lungs. You might have: Fever; Chest pains; Cough. Chills ... [9] Cutaneous signs are variable and may include solitary or multiple infected papules, nodules, pustules, abscesses, ulcers and scars. Reactive manifestations may ... [10] Result: fever | cough | back pain, aches, soreness, or discomfort

Diagnostic Tests for Coccidioidomycosis

Coccidioidomycosis, also known as Valley fever, is a fungal infection caused by the fungus Coccidioides. Diagnostic tests are essential to confirm the presence of this infection. Here are some of the diagnostic tests used to detect coccidioidomycosis:

• Serologic Tests: These tests detect the presence of antibodies against the fungus in the blood. They can be used to diagnose both IgM and IgG antibodies, which indicate current or past infection respectively [1][2].
• Skin Test: A skin test involves injecting a small amount of coccidioidal antigen into the skin. If you have been infected with Valley fever, your immune system will react to this antigen, causing a skin reaction [3].
• Blood Tests: Blood tests can be used to detect the presence of antibodies against the fungus in the blood. They are often used in combination with other diagnostic tests to confirm the diagnosis [4].
• Sputum Smear or Culture: These tests involve examining a sample of sputum (the matter that's discharged while coughing) for the presence of Coccidioides fungi [5].

Recommended Test Methods

The recommended test methods for coccidioidomycosis include enzyme immunoassay (EIA) antibody with immunodiffusion (ID) or complement fixation (CF) tests. These tests are sensitive and specific, making them useful for diagnosing both IgM and IgG antibodies [1].

Additional Tests

In addition to the above-mentioned tests, other diagnostic tests may be used in certain cases. For example, a skin test may be used to confirm past infection or current infection with Valley fever.

References:

[1] May 10, 2024 — Recommended test methods. [2] We use this test to detect both coccidioidal IgM (sometimes referred to as coccidioidal precipitins) and IgG (sometimes referred to as coccidioidal CF or ... [3] Apr 24, 2024 — Your healthcare provider may do a skin test to see if you had Valley fever in the past or are currently infected. [4] Oct 30, 2024 — Doctors will first look at your medical and travel history and the results of a physical exam. If Valley fever is suspected, a blood test can ... [5] by NM Ampel · 2010 · Cited by 88 — Available diagnostic tests. For the past several decades three modalities - culture, microscopy, and serology - have been the mainstays of specific diagnosis of ...

Treatment Options for Coccidioidomycosis

Coccidioidomycosis, also known as Valley fever, can be treated with antifungal medications in some cases. The treatment options depend on the severity and location of the infection.

• Mild cases: Most people who get Valley fever don't need treatment. However, if symptoms persist for eight weeks or longer, treatment with antifungal medications may be prescribed.
• Moderate to severe cases: Antifungal drugs such as fluconazole, itraconazole, and ketoconazole are used to treat serious infections. The preferred treatment is an oral triazole with fluconazole favored over itraconazole [1].
• Rapidly progressing coccidioidal infection: Amphotericin B is the drug of choice for rapidly progressing coccidioidal infection and disease nonresponsive to oral azole therapy [4].
• Extrapulmonary soft tissue coccidioidomycosis: Antifungal therapy is recommended in all cases, with oral azoles being a preferred option [9].

Approved Treatment Options

Ketoconazole is the only antifungal medication approved by the US Food and Drug Administration (FDA) for the treatment of coccidioidomycosis [8]. However, other antifungal medications such as fluconazole and itraconazole may also be used to treat the infection.

References

[1] NM AMPEL · 2015 - When antifungal therapy is prescribed, the preferred treatment is an oral triazole with fluconazole favored over itraconazole. [3] by JN Galgiani · 2000 - Therapy is usually initiated with oral azole antifungals (AII). [4] Dec 16, 2022 - Amphotericin B is the drug of choice for rapidly progressing coccidioidal infection and disease nonresponsive to oral azole therapy. [5] Ketoconazole was the first oral agent to be used in the treatment of coccidioidomycosis although only 20-30% of patients demonstrated a clinical response to 200 ... [6] Oct 30, 2024 - Treatment with antifungal medications may be prescribed for those with more severe symptoms or symptoms lasting eight weeks or longer. [7] Oct 29, 2024 - Treatment of mild-to-moderate pulmonary coccidioidal infection: Therapy with an oral triazole antifungal agent is appropriate for patients who ... [8] Dec 16, 2022 - Of the azoles, ketoconazole is the only one that is approved by the US Food and Drug Administration (FDA) for treatment of coccidioidomycosis. [9] Jul 27, 2016 - We recommend antifungal therapy in all cases of extrapulmonary soft tissue coccidioidomycosis (strong, moderate).

Differential Diagnosis of Coccidioidomycosis

Coccidioidomycosis, also known as Valley fever, is a fungal infection caused by the Coccidioides species. The differential diagnosis of this condition involves considering various other diseases that may present with similar symptoms.

Key Differential Diagnoses:

• Erythema nodosum: A skin condition characterized by red, painful nodules, which can be a symptom of coccidioidomycosis.
• Lymphoma: A type of cancer that affects the lymphatic system and can present with similar symptoms to coccidioidomycosis.
• Influenza: A viral infection that can cause respiratory symptoms, such as cough and fever, which are also common in coccidioidomycosis.
• Viral infections with generalized rashes: Certain viral infections can cause a rash, which may be mistaken for the skin lesions associated with coccidioidomycosis.
• Other fungal infections: Fungal diseases like histoplasmosis and blastomycosis can present with similar symptoms to coccidioidomycosis.

Diagnostic Considerations:

To diagnose coccidioidomycosis, healthcare providers consider the patient's clinical presentation, epidemiologic characteristics, and laboratory test results. Chest x-rays, cultures, and serologic testing are commonly used to confirm the diagnosis.

References:

• [1] Coccidioidomycosis can be diagnosed microscopically by visualization of endospore-containing spherules in infected material. Potassium hydroxide (KOH) wet mount is a common method for this purpose.
• [3] Differential Diagnosis: Influenza, viral infections with generalized rashes, other fungal infections, tuberculosis, and conditions associated with erythema nodosum are considered in the differential diagnosis of coccidioidomycosis.
• [9] Most commonly, the diagnosis of coccidioidomycosis is based on a positive coccidioidal serological test and a compatible clinical syndrome.