Also known as
San Joaquin fever, desert fever or coccidiomycosis
Description
- This is a fungal infection caused by Coccidioides immitis, which comes from a mold that grows in the soil of the southwestern US (especially deserts of Arizona), Mexico, and Central and South America. The infection occurs when dust containing this mold is inhaled. It is not spread person-to-person. Most individuals have an uncomplicated syndrome that lasts about 3 months. The more severe disease syndromes occur usually (but not always) in those with risk factors, or in certain ethnic groups.
Symptoms
- Common Infection (in most cases):
-
- Flu-like illness of dry cough, fatigue, headache, and backache
- Joint aches and swelling may occur.
- Rash
- Severe Infection:
- Lymph node enlargement
- Lung abscesses
- Diffuse lung disease
How the diagnosis is made
- Skin test — becomes positive in 3 weeks to 2-3 months and may last indefinitely.
- Blood titer test (IgM antibody rises within 2 weeks and disappears in 2 months; IgG rises within 1-3 months)
- Spinal tap if Meningitis suspected
- Cultures of sputum, joint fluid, or wounds may grow the fungus.
- Imaging
– Chest X-Ray will show cavities, infiltrate, enlarged hilar nodes, or mediastinal nodes.
Risk Factors
- Filipinos
- African Americans
- HIV-infected individuals
- Immuno-suppressed individuals (e.g., taking cancer chemotherapy)
Treatment
- Uncomplicated syndrome — no treatment
- Disseminated syndrome — amphotericin B intravenously
- Meningitis — Amphotericin B intravenously followed by oral fluconazole indefinitely in severe cases
- Severe cases limited to chest only — oral fluconazole or similar oral medications
- Surgical treatment if abscess forms and/or ruptures