• Coccidioidomycosis

    (Valley Fever)

    Definition

    Coccidioidomycosis, commonly called valley fever, is a potentially-serious lung infection.

    Causes

    Valley fever is caused by a fungal infection. The fungus that causes valley fever is found in the soil, most commonly in the southwestern United States, Mexico, and parts of Central and South America. Though the fungus lives in the soil, it is transported through the air and into the lungs, where it infects people who breathe it in. When soil that contains the fungus is disturbed, spores are released into the air.
    The disease cannot be transmitted from person to person.

    Risk Factors

    People who are at increased risk of exposure to the fungus include:
    • Farmers
    • Construction workers
    • People in the military
    • Archaeologists
    • People who work with or who are frequently exposed to soil, especially in the form of dust
    People who are at increased risk of getting valley fever after exposure include:
    • People with weakened immune systems
    • Elderly people
    • African Americans
    • Asians
    • Women in the third trimester of pregnancy

    Symptoms

    Most people have no symptoms of valley fever. If present symptoms may include:
    • Cough
    • Fever
    • Chest pain
    • Shortness of breath
    • Chill
    • Flu-like symptoms that lasts for weeks or a month, including
      • Night sweats
      • Headache
      • Aching in the joints
    • Rash that consists of painful red bumps
    • Fatigue that lasts longer than a few weeks
    The fungus can affect other parts of the body besides the lungs, and is called disseminated valley fever.

    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor may ask about recent travel.
    Your bodily fluids may be tested. This can be done with:
    • Blood tests
    • Sputum smear or culture
    • Spinal fluid analysis if there are neurologic symptoms
    • Tests from other infected sites
    X-rays or CT scan may be done to see how much your lungs have been affected.

    Treatment

    Talk with your doctor about the best treatment plan for you. Treatment options include:
    • Bed rest and fluids—Many people with valley fever do not need treatment with medication. The infection will go away on its own. Bed rest and drinking plenty of fluids will quicken recovery.
    • Antifungal medication—May be prescribed for those with weakened immune systems, chronic diseases, severe pneumonia, disseminated valley fever, meningitis, or primary infection in third trimester of pregnancy.

    Prevention

    To help reduce your chance of getting valley fever:
    • Always wear an N95 dust respirator mask when working in the soil or in dusty areas like construction sites.
    • Promptly clean wounds with soap and water, especially if they had contact with dust or soil.
    • Avoid activiities that put you in contact with soil, such as gardening or digging..
    • Stay indoors during dust storms. Seal windows and doors tightly.
    • If you have a suppressed immune system or other risk factors, talk to your doctor about taking preventive medications.
    • Talk to your doctor about recombinant coccidioidal protein antigens that may offer protection like a vaccine. Vaccine options are currently being evaluated in clinical trials.

    RESOURCES

    Family Doctor—American Academy of Family Physicians http://familydoctor.org

    Valley Fever Connections http://www.valley-fever.org

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    Public Health Agency of Canada http://www.phac-aspc.gc.ca

    References

    Ampel NM. New perspectives on coccidioidomycosis. Proc Am Thorac Soc. 2010;7(3):181-185.

    Coccidioidomycosis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116164/Coccidioidomycosis. Updated August 23, 2016. Accessed September 27, 2016.

    Ampel NM, Giblin A, Mourani JP, Galgiani JN. Factors and outcomes associated with the decision to treat primary pulmonary coccidioidomycosis. Clin Infect Dis. 2009;48(2):172-178.

    Fisher BT, Chiller TM, Prasad PA, et al. Hospitalizations for coccidioidomycosis at forty-one children's hospitals in the United States. Pediatr Infect Dis J. 2010;29(3):243-247.

    Galgiani JN. Valley fever tutorial for primary care professionals. The Valley Fever Center for Excellence website. Available at http://www.vfce.arizona.edu/resources/pdf/Tutorial%5Ffor%5FPrimary%5Fcare%5FPhysicians.pdf. Updated January 2015. Accessed December 9, 2015.

    Hector RF, Rutherford GW, Tsang CA, et al. The public health impact of coccidioidomycosis in Arizona and California. Int J Environ Res Public Health. 2011;8(4):1150-1173.

    Valley fever in people. Valley Fever Center for Excellence website. Available at: https://www.vfce.arizona.edu/ValleyFeverInPeople/Default.aspx. Accessed December 9, 2015.

    Valley fever (coccidioidomycosis) risk & prevention. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/fungal/diseases/coccidioidomycosis/risk-prevention.html. Updated April 17, 2015. Accessed December 9, 2015.

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