Pulmonary coccidioidomycosis is an infection in the lungs that is caused by the fungus Coccidioides. Coccidioidomycosis is commonly called valley fever. You can get valley fever by inhaling spores from Coccidioides immitis and Coccidioides posadasii fungi. The spores are so small that you cannot see them. Valley fever fungi are commonly found in soil in the desert regions of the southwestern United States and in Central and South America.
The California Department of Public Health estimates that about 150,000 people in the United States contract valley fever every year (CDPH).
There are two types of pulmonary coccidioidomycosis: acute and chronic.
Acute coccidioidomycosis is a mild form of the infection. Symptoms of the acute infection begin one to three weeks after inhaling the fungal spores and may go unnoticed. It usually goes away without treatment.
Chronic coccidioidomycosis is a long-term form of the illness. You can develop the chronic form months or years after contracting the acute form, sometimes as much as 20 years or more after the initial illness. In the chronic form of the illness, lung abscesses (infections) can form and rupture (burst) releasing pus into the space between the lungs and ribs. Scarring may occur as a result.
The majority of people infected with this fungus do not develop the chronic form of pulmonary coccidioidomycosis.
You can only get valley fever by directly inhaling the spores from the valley fever fungus in the soil. Once the fungus spores enter a person’s body, they change form and cannot be transmitted to another person. You cannot get valley fever from contact with another person.
You may not have any symptoms if you have the acute form of valley fever. If you do have symptoms, you may mistake them for a common cold, cough, or flu. Symptoms you may experience with the acute form include:
- loss of appetite
- shortness of breath
Symptoms of the chronic form are similar to those of tuberculosis. Symptoms you may experience with the chronic form include:
- a chronic cough
- blood-tinged sputum (coughed up mucus)
- weight loss
- chest pain
- muscle aches
Your doctor may perform one or more of the following tests to make a diagnosis:
- blood test to check for Coccidioides fungi in the blood
- chest X-ray to check for damage to your lungs
- culture tests on sputum (mucus you cough up from your lungs) to check for Coccidioides fungi
You most likely will not need treatment for the acute form of valley fever. Your doctor will suggest that you get plenty of rest until your symptoms disappear.
If you have a weakened immune system or have the chronic form of the illness, your doctor may prescribe antifungal medications to kill the valley fever fungi. Common antifungal medications prescribed for valley fever include amphotericin B, fluconazole, and itraconazole. Rarely, for chronic valley fever, surgery is required to remove the infected or damaged parts of your lungs.
You should see your doctor if you are displaying symptoms of valley fever. You should also visit your doctor if your symptoms do not go away with treatment or if you develop new symptoms.
Anyone who visits or lives in areas where valley fever exists can contract the illness. You have an increased risk of developing the chronic form of the illness if you:
- are of African, Filipino, or Native American descent
- have a weakened immune system
- are pregnant
- have heart or lung disease
- have diabetes
If you have acute valley fever, you most likely will get better without any complications. You may experience relapses during which the fungal infection returns.
If you have the chronic form or have a weakened immune system, you may need to take antifungal medications for months or even years. The chronic form of the infection can cause lung abscesses and scarring in your lungs. There is about a one percent chance that the fungal infection could spread to the rest of your body, causing disseminated valley fever, according to the Centers for Disease Control and Prevention (CDC, 2009). Disseminated valley fever is often fatal.
Because the illness is usually not serious, most people do not need to worry about traveling to areas where valley fever fungi are found. People with immune system problems—such as people who have AIDS or take immunosuppressive medications—should avoid traveling to areas where valley fever fungi grow because they are more likely to develop the disseminated form of the illness.