Coccidioidomycosis and Valley Fever Questions & Answers

Updated: Aug 27, 2019
  • Author: Duane R Hospenthal, MD, PhD, FACP, FIDSA, FASTMH; Chief Editor: Michael Stuart Bronze, MD  more...
  • Print
Questions & Answers

Overview

What is coccidioidomycosis?

How is coccidioidomycosis transmitted?

What are the signs and symptoms of coccidioidomycosis?

What is disseminated coccidioidomycosis?

What is required for the diagnosis of coccidioidomycosis?

What is the role of antifungal therapy in the treatment of coccidioidomycosis?

When was coccidioidomycosis first identified?

What is the pathophysiology of coccidioidomycosis?

What is the role of cell-mediated immunity in the pathogenesis of coccidioidomycosis?

What causes lymphangitis in the pathophysiology of coccidioidomycosis?

What is the role of spherules in the pathophysiology of coccidioidal infections?

What is the pathophysiology of nonrespiratory transmission of coccidioidomycosis?

What is the pathophysiology of disseminated coccidioidomycosis?

What causes coccidioidomycosis?

What is the life cycle of Coccidioides?

Where is Coccidioides (C immitis and C posadasii) endemic?

In which areas of the US is Coccidioides (C immitis and C posadasii) endemic?

Which occupations pose the greatest risk for developing coccidioidomycosis?

What is the incidence of coccidioidomycosis in the US?

What are the coccidioidal infection rates in endemic areas of the US?

What is the socioeconomic impact of coccidioidomycosis in the US?

When is routine testing of students for coccidioidomycosis indicated in endemic areas?

What is the global prevalence of coccidioidomycosis?

What is the incidence of coccidioidomycosis outside of the Western Hemisphere?

What are the racial predilections for coccidioidomycosis?

How does the incidence of coccidioidomycosis vary by sex?

How does the incidence of coccidioidomycosis vary by age?

What is the prognosis of coccidioidomycosis?

Which factors increase the risk for severe coccidioidomycosis?

What is the prognosis of disseminated coccidioidomycosis?

What is the morbidity and mortality associated with coccidioidomycosis?

What should be included in patient education for coccidioidomycosis?

Presentation

What is the clinical progression of coccidioidomycosis?

What are the symptoms of coccidioidomycosis?

What is the clinical progression of primary pulmonary coccidioidomycosis?

Which history is characteristic of coccidioidomycosis?

Which factors increase the risk for disseminated coccidioidomycosis?

Which physical findings are characteristic of coccidioidomycosis?

What are symptoms of respiratory (pulmonary) coccidioidomycosis?

What is the common manifestation of pulmonary involvement in coccidioidomycosis?

What are less common pulmonary manifestations of coccidioidomycosis?

What are dermatologic findings characteristic of coccidioidomycosis?

What is the musculoskeletal findings characteristic of coccidioidomycosis?

How is coccidioidomycosis manifested in the joints?

What are less common physical findings of coccidioidomycosis?

Which physical findings suggest meningitis in disseminated coccidioidomycosis?

What are physical findings suggestive of septic shock in coccidioidomycosis?

What is coccidioidal fungemia in coccidioidomycosis?

DDX

Which factors are used to narrow the differential diagnoses of coccidioidomycosis?

Which conditions should be included in the differential diagnoses of coccidioidomycosis?

Which conditions should be included in the differential diagnoses of coccidioidomycosis with cystic lesions seen on chest imaging studies?

Which conditions should be included in the differential diagnoses of coccidioidomycosis with focal or multifocal cavitary lesions seen on chest imaging studies?

Which conditions should be included in the differential diagnoses of coccidioidomycosis with cystic or cavitary lesions seen on chest imaging studies?

What are the differential diagnoses for Coccidioidomycosis and Valley Fever?

Workup

Which general lab studies are included in the workup of coccidioidomycosis?

Which specific lab tests are included in the workup of coccidioidomycosis?

How is coccidioidomycosis diagnosed?

What is the role of imaging studies in the workup of coccidioidomycosis?

What is the role of serologic studies in the workup of coccidioidomycosis?

What is the role of immunoglobulin M (IgM) detection in the workup of coccidioidomycosis?

Which methods of immunoglobulin M (IgM) detection are used in the workup of coccidioidomycosis?

What is the significance of the appearance of immunoglobulin M (IgM) in the workup of coccidioidomycosis?

What is the role of immunoglobulin G (IgG) detection in the workup of coccidioidomycosis?

What is the role of cultures in the workup of coccidioidomycosis?

What is the role of polymerase chain reaction (PCR) assays in the workup of coccidioidomycosis?

What is the role of skin testing in the workup of coccidioidomycosis?

Which skin testing finding is a negative prognostic factor for coccidioidomycosis?

What is the role of imaging studies in the workup of coccidioidomycosis?

What is the role of lumbar puncture in the workup of coccidioidomycosis?

What is the role of bronchoscopy in the workup of coccidioidomycosis?

What is the role of biopsy in the workup of coccidioidomycosis?

Which histologic findings are diagnostic of coccidioidomycosis?

Treatment

Which factors determine treatment options for coccidioidomycosis?

What is the decision-making process for treatment selection in coccidioidomycosis?

How is the severity of coccidioidomycosis determined?

What are risk factors for dissemination of coccidioidomycosis?

What are the goals of treatment for coccidioidomycosis?

What is the role of amphotericin B in the treatment of coccidioidomycosis?

What is the first line of therapy for coccidioidomycosis?

What is the role of azoles in the treatment of coccidioidomycosis?

What is the role of combination therapies in the treatment of coccidioidomycosis?

What is the role of posaconazole for the treatment of coccidioidomycosis?

What is the role of caspofungin for the treatment of coccidioidomycosis?

What is the duration of antifungal therapy for coccidioidomycosis?

What are possible complications of antifungal medication for the treatment of coccidioidomycosis?

What are the costs of antifungal therapy for coccidioidomycosis?

What is the role of interferon-gamma in the treatment of coccidioidomycosis?

What are the disease stages of coccidioidomycosis?

How frequently does uncomplicated acute pneumonia in coccidioidomycosis resolve spontaneously?

What are the indications for treatment of uncomplicated acute pneumonia in coccidioidomycosis?

What are the treatment options for uncomplicated acute pneumonia in coccidioidomycosis?

What is the treatment for an asymptomatic pulmonary nodule in coccidioidomycosis?

What is the treatment for diffuse pneumonia in coccidioidomycosis?

What is the treatment for a pulmonary cavity in coccidioidomycosis?

What is the treatment for chronic progressive pneumonia in coccidioidomycosis?

What is the role of surgery in the treatment of chronic progressive pneumonia in coccidioidomycosis?

What is the treatment for disseminated coccidioidomycosis?

What is the treatment for disseminated coccidioidomycosis with bone and joint involvement?

What is the treatment for septic shock in coccidioidomycosis?

What is the treatment for coccidioidal meningitis?

What must be considered when treating coccidioidomycosis in high-risk patients?

How is coccidioidomycosis treated during pregnancy?

What is the incidence of coccidioidomycosis in transplant recipients?

What is the treatment of coccidioidomycosis during the pretransplant period?

What is the treatment of coccidioidomycosis during the posttransplant period?

How is the risk of coccidioidomycosis transmitted by donor organ managed?

What is the treatment for coccidioidomycosis in HIV-infected patients?

What is the treatment for coccidioidomycosis in patients on antitumor necrosis factor therapy?

What is the treatment for coccidioidomycosis in elderly patients?

When is inpatient treatment indicated for coccidioidomycosis?

What is included in inpatient treatment of coccidioidomycosis?

How is coccidioidomycosis prevented?

What is the role of vaccines in the prevention of coccidioidomycosis?

Which specialist consultations are needed for the treatment of coccidioidomycosis?

What is including in long-term monitoring of coccidioidomycosis?

Guidelines

What are the Infectious Diseases Society of America (IDSA) treatment guidelines for coccidioidomycosis?

Medications

What is the role of drug treatment for coccidioidomycosis?

Which medications in the drug class Antifungals are used in the treatment of Coccidioidomycosis and Valley Fever?