A disease caused by breathing in a fungus (Coccidioides immitis) found in the soil in certain parts of the southwestern United States, Mexico, and Central and South America that spreads through the bloodstream to involve many organs.
Alternative Names
Systemic coccidioidomycosis
Causes, incidence, and risk factors
This is caused by breathing in the spores of a fungus in desert regions. About 60% of acute infections cause no symptoms and are only recognized by a positive coccidioidin skin test . In the remaining 40%, symptoms range from mild to severe. In disseminated disease, extension of infection to the bones, lungs, liver, meninges, brain, skin, heart, and pericardium (sac around the heart) may take place. Meningitis occurs in 30% to 50% of cases of disseminated disease. Immunodeficient ( immunosuppressed ) people, including those with HIV infection , diabetics, and pregnant women of any race are more prone to dissemination. Recent travel to or residence in southwestern deserts of the United States is a risk factor.
Signs and tests
sputum smear (KOH test)sputum culture serum coccidioides complement fixation titer
coccidioidin skin test CBC with differential
chest X-raybiopsy of tissue in area of disseminated disease bone marrow biopsyliver biopsyopen lung biopsyskin lesion biopsy changes in neurological examination
Treatment
Bed rest and supportive treatment, especially improved nutrition, are indicated. Antifungal medications are prescribed to treat the infection.
Expectations (prognosis)
People with disseminated disease have a high death rate. The course may be rapid for immunosuppressed patients.
Complications
This can be a fatal disorder.
Calling your health care provider
Call for an appointment with your health care provider if symptoms of disseminated coccidioidomycosis develop.
Prevention
General maintenance of good health will limit the disease to a benign pulmonary form. Prevention of AIDS or other causes of impaired immune system will generally prevent the more severe forms of the disease.