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| Sometimes called Valley Fever or Desert Fever because of its prevalence in farming valleys, these fungi resist drying and easily become airborne. An example of such infectivity was noted following a large California dust storm after which 15 counties reported a tenfold or more increase in cases of coccidioidomycosis. Diseases and conditions that alter immune responses also predispose those affected to dissemination and serious disease. Pregnant women are at special risk for disseminated coccidioidomycosis. Blacks and Hispanics also have a higher risk of dissemination than whites. The incidence is equal in males and females and persons of any age may be affected. In disseminated disease, the mortality rates in newborns and infants are much higher than those in children, adolescents and adults. About 60% of infections cause no symptoms and are only recognized by a positive coccidioidin skin test. Cellular immunity, particularly T-cells, becomes a key factor in determining recovery from coccidioidomycosis. A respiratory infection ensues. The majority of patients recover from the respiratory infection with no or minimal consequences. Some develop complications in the lungs, such as tissue death or abscesses. Disseminated disease can involve nearly every organ and can be especially dangerous in the immune compromised host. Chronic pulmonary coccidioidomycosis can develop 20 or more years after initial infection which may not have been recognized, diagnosed, or treated. Treatment & Prevention The acute disease almost always goes away without treatment. The results of medical therapies for coccidioidomycosis are unpredictable. Antifungal therapy for coccidioidomycosis often is less certain than for other fungal diseases. Common drugs used include Amphotericin B, Diflucan, and Nizoral. Prognosis; Complications About 40% of those infected develop symptomatic disease, usually pulmonary. People with disseminated disease have a high death rate. |
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