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Coccidioidomycosis

(Valley Fever)

Definition

Coccidioidomycosis, commonly called valley fever, is a fungal infection of the lungs that can cause serious problems.

Causes

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. The fungus lives in the soil, but 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
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

Some people have no symptoms of valley fever. Others may have:
  • 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, but it is then called disseminated valley fever.

Diagnosis

Your doctor will ask about your symptoms and medical history, and do a physical exam.
Your bodily fluids may be tested. This can be done with:
  • Blood tests
  • Sputum smear or culture

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:
  • Bed rest and fluids—Many patients 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—Some patients, especially those with weakened immune systems, chronic diseases, severe pneumonia, disseminated valley fever, meningitis, or primary infection in third trimester of pregnancy may be prescribed an antifungal medication.

Prevention

There is no completely effective way to prevent being infected with valley fever. Take extra precautions in areas where the infection is most common and during months when the chance of infection is increased.
To help reduce your chances of getting valley fever, take the following steps:
  • When working outside in the soil, especially in areas where the fungus is common, you should:
    • Always wear a mask.
    • Wet the soil to reduce the spores in the air.
  • Keep doors and windows tightly closed in areas where the fungus is common.
  • Go inside during a dust storm.

RESOURCES

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 May;7(3):181-185.

Ampel NM, Giblin A, Mourani JP, Galgiani JN. Factors and outcomes associated with the decision to treat primary pulmonary coccidioidomycosis. Clin Infect Dis. 2009 Jan 15;48(2):172-178.

Environmental mediation of valley fever. University of Arizona Tucson website. Available at: http://www.casa.arizona.edu/~peter/valleyfever/web/index.html . Accessed September 18, 2013.

Fisher BT, Chiller TM, et al. Hospitalizations for coccidioidomycosis at forty-one children's hospitals in the United States. Pediatr Infect Dis J. 2010 Mar;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 2012. Accessed September 18, 2013.

Hector RF, Rutherford GW, 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 humans. Valley Fever Center for Excellence website. Available at: https://www.vfce.arizona.edu/ValleyFeverInPeople/Default.aspx . Accessed September 18, 2013.

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