Coccidioidomycosis

Coccidioidomycosis, also known as Valley fever, San Joaquin Valley fever, or desert rheumatism, is an infectious disease caused by the dimorphic fungi Coccidioides immitis and Coccidioides posadasii. These fungi are found in the soil of arid and semi-arid regions, particularly the southwestern United States, Mexico, and parts of Central and South America. Infection occurs when airborne arthroconidia (fungal spores) are inhaled, primarily affecting the respiratory system. While coccidioidomycosis is an infectious disease rather than a genetic disorder, certain individuals may have genetic susceptibility factors that predispose them to severe or disseminated forms of the disease. Approximately 60% of infected individuals remain asymptomatic, while about 40% develop a primary pulmonary illness characterized by cough, fever, chest pain, fatigue, shortness of breath, headache, night sweats, and joint pain. In most cases, the infection is self-limited and resolves without treatment. However, in a small percentage of patients (roughly 1-5%), the disease disseminates beyond the lungs to affect the skin, bones, joints, soft tissues, and central nervous system, including potentially life-threatening coccidioidal meningitis. Risk factors for disseminated disease include immunosuppression (such as HIV/AIDS, organ transplantation, or immunosuppressive therapy), pregnancy (particularly the third trimester), and certain ethnic backgrounds, with individuals of African, Filipino, and Native American descent at higher risk for severe disease. Treatment depends on the severity and extent of infection. Mild pulmonary coccidioidomycosis may be managed with observation alone. Moderate to severe pulmonary disease and all forms of disseminated disease require antifungal therapy, typically with azole antifungals such as fluconazole or itraconazole. Severe or life-threatening infections, including meningitis, may require amphotericin B. Coccidioidal meningitis generally requires lifelong antifungal therapy. Surgical intervention may be necessary for certain complications, such as pulmonary cavities or bone and joint involvement.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

Common questions about Coccidioidomycosis