II. Epidemiology

  1. Important opportunistic infection in southwestern US

III. Pathophysiology

  1. Infection with fungus Coccidioides immitis

IV. Symptoms

  1. Chills, weight loss
  2. Productive cough
  3. Chest Pain
  4. Arthralgias

V. Signs

  1. Fever
  2. Cervical adenopathy
  3. Skin lesions
    1. Resemble Erythema Nodosum
  4. Lung
    1. Pleural Effusion
    2. Friction rub
    3. Pulmonary rales

VI. Lab

  1. Sputum KOH
    1. Positive for fungal elements
  2. Blood complement-fixing antibodies
    1. Positive

VII. Diagnosis

  1. Coccidioidomycosis serology: IgM
    1. IgM positive by third week in 90% of patients
    2. Becomes negative 3 months after infection
  2. Complement fixation of IgG
    1. Low sensitivity, but high Specificity
  3. Skin Testing (for epidemiologic studies)
    1. Coccidioidin skin test
    2. Spherulin skin test

VIII. Differential Diagnosis in HIV patients

IX. Affected Organs

  1. Lung most commonly affected (similar to Pneumocystis)

X. Management

  1. Disseminated disease
    1. Amphotericin B
  2. Palliative Therapy
    1. Fluconazole 600-800 mg/day
    2. Itraconazole 400 mg/day

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Ontology: Coccidioides immitis (C0009184)

Definition (MSH) The sole species of COCCIDIOIDES. It can cause an acute, benign respiratory infection as well as a fatal, chronic systemic disease.
Definition (CSP) mitosporic fungal species which causes coccidiodomycosis.
Concepts Fungus (T004)
MSH D003045
SnomedCT 23439005
LNC LP14437-5, MTHU009316
English Malbranchea of Coccidi immitis, immitis, Coccidioides, immitides, Coccidioides, Coccidioides immitides, coccidioides immitis, Malbranchea state of Coccidioides immitis, Coccidioides immitis (organism), Coccidioides immitis
Portuguese Coccidioides immitis
German Coccidioides immitis
French Coccidioides immitis
Czech Coccidioides immitis
Italian Coccidioides immitis
Norwegian Coccidioides immitis
Spanish Coccidioides immitis (organismo), Coccidioides immitis
Dutch Coccidioides immitis

Ontology: Coccidioidomycosis (C0009186)

Definition (MSHCZE) Druh orgánové mykózy způsobené houbou Coccidioides immitis, která je endemická v některých oblastech USA. Postihuje plíce, CNS, lymfatické uzliny aj. V těžkých případech dochází k diseminaci. Častější je u osob s oslabenou imunitou, např. u AIDS. Léčí se antimykotiky. (cit. Velký lékařský slovník online, 2012 http://lekarske.slovniky.cz/ )
Definition (MEDLINEPLUS)

Valley Fever is a disease caused by a fungus (or mold) called Coccidioides. The fungi live in the soil of dry areas like the southwestern U.S. Anyone exposed to the fungus can get the infection. The highest risk is for people whose jobs expose them to soil dust. These include construction workers, agricultural workers, and military forces doing field training. The infection cannot spread from person to person.

Valley Fever is often mild, with no symptoms. If you have symptoms, they may include a flu-like illness, with fever, cough, headache, rash and muscle aches. Most people get better within several weeks or months. A small number of people may develop a chronic lung or widespread infection.

Valley Fever is diagnosed by testing your blood, other body fluids, or tissues. Many people with the acute infection get better without treatment. In some cases, doctors may prescribe antifungal drugs for acute infections. Severe infections require antifungal drugs.

Centers for Disease Control and Prevention

Definition (NCI) A fungal infection caused by Coccidioides immitis. Affected individuals usually have mild flu-like symptoms. However, pneumonia and systemic involvement with the formation of abscesses may develop as complications of the disease.
Definition (CSP) infection with a fungus of the genus Coccidioides, species C. immitis; primary form is an acute, benign, self limited respiratory infection due to inhalation of spores and varying in severity; secondary form is a virulent, severe, chronic, progressive granulomatous disease with systemic involvement.
Definition (MSH) Infection with a fungus of the genus COCCIDIOIDES, endemic to the SOUTHWESTERN UNITED STATES. It is sometimes called valley fever but should not be confused with RIFT VALLEY FEVER. Infection is caused by inhalation of airborne, fungal particles known as arthroconidia, a form of FUNGAL SPORES. A primary form is an acute, benign, self-limited respiratory infection. A secondary form is a virulent, severe, chronic, progressive granulomatous disease with systemic involvement. It can be detected by use of COCCIDIOIDIN.
Concepts Disease or Syndrome (T047)
MSH D003047
ICD9 114.9, 114
ICD10 B38 , B38.9
SnomedCT 442543009, 60826002, 266218008, 187035003, 187025009, 154408001, 187481007
LNC LA10444-0
English Coccidioidomycoses, Coccidioidomycosis, unspecified, Coccidioidomycosis,unspecfd, [X]Coccidioidomycosis, unspecified, [X]Coccidioidomycosis,unspecfd, San Joaquin valley fever, desert fever, coccidioidomycosis (diagnosis), coccidioidomycosis, Infection by Coccidioides immitis (disorder), Infection by Coccidioides immitis, Coccidioidomycosis NOS, Coccidioidomycosis [Disease/Finding], Coccidioides immitis Infection, Coccidioides immitis Infections, Valley Fevers, Valley Fever, Infection, Coccidioides immitis, Infections, Coccidioides immitis, San Joaquin Valley Fever, disease posada wernicke, [X]Coccidioidomycosis, unspecified (disorder), Coccidioidomycosis NOS (disorder), Coccidioides immitis infection, Valley fever, Posadas-Wernicke disease, Coccidioidomycosis (disorder), Posada-Wernicke, San Joaquin (Valley); fever (etiology), San Joaquin (Valley); fever (manifestation), Wernicke-Posada, fever; San Joaquin (Valley) (etiology), fever; San Joaquin (Valley) (manifestation), Coccidioidomycosis, NOS, Coccidioidomycosis, San Joaquin Valley fever
Dutch Coccidioides immitis-infectie, coccidioïdomycose, niet-gespecificeerd, San Joaquin Valley-koorts, San Joaquin; fever, fever; San Joaquin, Coccidioïdomycose, niet gespecificeerd, coccidioïdomycose, Coccidioïdomycose, Coccidioidomycose, Mycose, coccidioido-
French Coccidiomycose, non précisée, Infection à Coccidioides immitis, Fièvre de la Vallée de San Joaquin, Fièvre de la vallée de San Joaquin, Coccidiomycose, Coccidioïdomycose, Fièvre du désert, Fièvre de San Joaquin
German Coccidioides immitis-Infektion, Kokzidioidomykose, unspezifisch, San-Joaquin-Fieber, Kokzidioidomykose, nicht naeher bezeichnet, Coccioidesmykose, Kokzidioidomykose
Italian Coccidioidomicosi non specificata, Infezione da Coccidioides immitis, Febbre della valle di San Joaquin, Coccidioidomicosi
Portuguese Infecção por Coccidioides immitis, Coccidioidomicose NE, Febre do vale San Joaquin, Coccidioidomicose
Spanish Infección por Coccidiodes immitis, Coccidioidomicosis no especificada, Fiebre del valle de San Joaquín, infección por Coccidioides immitis, infección por Coccidioides immitis (trastorno), [X]coccidioidomicosis, no especificada (trastorno), coccidioidomicosis, SAI (trastorno), coccidioidomicosis, SAI, [X]coccidioidomicosis, no especificada, coccidioidomicosis, coccidioidomicosis (trastorno), enfermedad de Posadas - Wernicke, Coccidioidomicosis
Swedish Koccidioidomykos
Japanese コクシジオイデスショウ, コクシジオイデスイミチスカンセン, コクシジオイデス症、詳細不明, コクシジオイデスショウショウサイフメイ, サンホアキン渓谷熱, コクシジオイデス・イミチス感染, サンホアキンケイコクネツ, コクシジオイデス症, コクシジオイド症, 谷熱
Czech kokcidioidomykóza, Blíže neurčená kokcidioidomykóza, Kokcidioidomykóza, Infekce prvokem Coccidioides immitis, Horečka údolí San Joaquin, horečka údolí, horečka údolí San Joaquin
Finnish Koksidioidomykoosi
Korean 콕시디오이데스진균증, 상세불명의 콕시디오이데스진균증
Polish Kokcidioidomikoza, Choroba kalifornijska, Zakażenie Coccidioides, Gorączka Doliny św. Joachima, Choroba Pasady i Wernickiego, Grzybica kokcydioidowa
Hungarian coccidioidomycosis, Coccidioides immitis fertőzés, Coccidioidomycosis, nem meghatározott, San Joaquin-völgyi láz
Norwegian Koksidioidomykose

Ontology: coccidiomycosis (C0262426)

Concepts Disease or Syndrome (T047)
English coccidiomycosis