Coccidioidomycosis
(Valley Fever)
Definition
Coccidioidomycosis, commonly called valley fever, is a fungal infection of the lungs that can cause very serious problems. The fungus is found in the soil—most commonly in the southwestern United States, Mexico, and parts of Central and South America. The fungus can also affect other parts of the body besides the lungs, but it is then called disseminated valley fever.
Causes
Valley fever is caused by breathing the fungus into the lungs. The fungus lives in the soil, but it is transported through the air and into the lungs, where it infects people. 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
Anyone is susceptible to valley fever, but certain people are at an increased risk:
- Farmers
- Construction workers
- People in the military
- Archaeologists
- People with weakened immune systems (mostly for disseminated valley fever)
- Elderly people
- African-Americans
- Asians
- Women in the third trimester of pregnancy
- People who work with or who are frequently exposed to soil
Talk to your doctor if you have any of these risk factors.
Symptoms
Some people have no symptoms of valley fever. Others have:
- Flu-like symptoms that lasts for weeks or a month
- Fatigue that lasts longer than a few weeks
- Fever
- Cough
- Chest pain
- Chill
- Night sweats
- Headache
- Aching in the joints
- Shortness of breath
- Rash that consists of painful red bumps
Diagnosis
Your doctor will ask about your symptoms and medical history, and do a physical exam.
Tests may include the following:
- Blood tests—to look for the presence of antibodies to defend against the fungus
- Sputum smear or culture—to look for the presence of the fungus in the sputum (mucus or phlegm that is coughed up)
Treatment
Talk with your doctor about the best treatment plan for you. Treatment options include:
-
Antifungal medicine—Some patients, especially those with weakened immune systems, may be prescribed an antifungal medicine. Drugs include
fluconazole
,
itraconazole
, or
amphotericin B
. These medicines help manage the fungus. But, a recurrence of valley fever can occur.
- Bed rest and fluids—Many patients with valley fever do not need treatment with medicine. The infection will go away on its own. Bed rest and drinking plenty of fluids will speed recovery.
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 down 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
Family Doctor.org
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):181-5.
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):172-8.
Environmental mediation of valley fever. University of Arizona Tucson website. Available at:
http://www.casa.arizona.edu/~peter/valleyfever/web/index.html
.
Accessed April 19, 2007.
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 Mar;29(3):243-7.
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
. Accessed October 31, 2011.
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. Valley Fever Connections website. Available at:
http://www.valley-fever.org/
.
Accessed April 19, 2007.
Valley fever in humans. Valley Fever Center for Excellence website. Available at:
http://www.vfce.arizona.edu/
.
Accessed April 19, 2007.