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Author: Brian Wu PhD. MD Candidate, Keck School of Medicine, Los Angeles, USA. Chief Editor: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, October 2015.
Coccidioidomycosis is a fungal infection that primarily affects the lungs and respiratory tract. It can in rare cases spread to other parts of the body.
Coccidioidomycosis is also known as San Joaquin Valley fever (or simply Valley fever) or desert rheumatism. It occurs in the western United States and parts of Mexico and Central and South America.
Coccidioidomycosis is caused by two distinct Coccidiodies species of soil fungus, Coccidioides immitis and Coccidioides posadaii.
The infection occurs through:
In 65% of cases, patients with coccidioidomycosis are asymptomatic.
Patients with mild or self-limiting infections will present with:
Primary cutaneous coccidioidomycosis is very rare and arises from an inoculation injury. It presents as an indurated nodule and is one of the causes of sporotrichoid spread associated with lymphadenopathy.
Disseminated coccidioidomycosis refers to the spread of lung infection to other organs.
This advance can be rapid and involve the soft tissues, joints, central nervous system, endocrine glands, eyes, liver, kidneys, peritoneal cavity and, most seriously, the meninges (lining around the brain). If untreated, coccidioides infections of the meninges are nearly always fatal.
Patients with disseminated coccidioidomycosis may present with:
Cutaneous signs are variable and may include solitary or multiple infected papules, nodules, pustules, abscesses, ulcers and scars.
Reactive manifestations may include:
Risk factors for coccidioidomycosis include:
Diagnosis of coccidioidomycosis is made through:
More severe cases may require additional testing, including:
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