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coccidioidomycosis

coccidioidomycosis , systemic fungus disease (see fungal infection ) endemic to arid regions of the Americas, contracted by inhaling dust containing spores of the fungus Coccidioides immitis. From the respiratory tract, it can spread to the skin, bones, and central nervous system. Manifestions of the disease range from complete absence of symptoms to systemic infection and death. In 60% of the cases no clinical evidence of the disease is present and the only recognizable sign is a positive skin test; in 15% symptoms resembling those of influenza occur; and in 25% more serious signs such as swelling of the knees, weakness, pleural pain, and prostration occur. Diagnosis is made upon positive cultural identification of the fungus. Treatment is with the antifungal amphotericin B and bed rest. The soil that supports Coccidioides spores is indigenous to dry, hot geographical areas; the SW United States, Argentina, and Paraguay are areas of high incidence of infection. Cases in the San Joaquin Valley in California, where the disease is called valley fever, increased tenfold between 1991 and 1995.

Bibliography: See M. J. Fiese, Coccidioidomycosis (1958); D. A. Stevens, ed., Coccidioidomycosis (1980).

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