Disseminated Coccidioidomycosis

Written by Cindie Slightham | Published on August 20, 2012
Medically Reviewed by George Krucik, MD

What is Disseminated Coccidioidomycosis?

Disseminated coccidioidomycosis is an airborne illness caused by the fungus Coccidioides immitis. When the infection is in your lungs it is called Valley Fever, but when it spreads from the lungs to other tissues it is known as disseminated coccidioidomycosis.

The condition requires immediate medical attention and is usually treated with antifungal agents. The infection can lead to a chronic condition if your body is not able to fight the fungus. Disseminated coccidioidomycosis can be fatal.

About the Coccidioidomycosis Infection

Coccidioidomycosis is an infection caused by the fungus Coccidioides immitis. This fungus is found in the western deserts of the United States and in Central and South America. In the United States it is usually located in:

  • California San Joaquin Valley
  • southern Arizona
  • southern New Mexico
  • western Texas

The fungus lives in the soil, and infection occurs when a person breathes in dust particles containing the fungus. The fungus does not spread from person to person.

Infection rates are highest in the late summer and early fall because the soil is dry and dust storms occur often. The fungus is unable to spread during periods of rainfall when the soil is damp.

Many cases resolve on their own, and many people have come in contact with the fungus but do not have any symptoms. According to the U.S. Centers for Disease Control and Prevention, approximately 60 percent of coccidioidomycosis cases have no symptoms. Patients who do have symptoms feel like they have the flu, and the disease is self-limiting, which means that it goes away on its own.

Approximately one percent of patients with coccidioidomycosis go on to develop disseminated coccidioidomycosis (CDC). When the disease progresses to disseminated coccidioidomycosis, it is often fatal, although that varies a great deal depending on the patient’s age and overall health. According to the Center for Food Security and Public Health at Iowa State University, about 30 to 50 percent of patients with untreated disseminated disease progress to meningitis, an infection of the brain and spinal cord, which is typically fatal (ISU).

Who Is at Risk of Contracting Disseminated Coccidioidomycosis?

Anyone can inhale the fungus and become infected, but you have a greater risk of becoming infected if you:

  • are a young infant, child, or older adult
  • inhale a lot of dust through construction, agricultural, or ranch work, military training, or archeology
  • have diabetes mellitus
  • are a pregnant woman
  • are African-American, Filipino, Asian, or Hispanic
  • have had an organ transplant
  • have AIDS or HIV

What Are the Symptoms of Disseminated Coccidioidomycosis?

According to the Centers for Disease Control and Prevention, around 60 percent of people who come in contact with the fungus don’t have any symptoms (CDC).

When the infection is in your lungs it can cause flu-like symptoms:

  • cough
  • chest pain
  • fever
  • chills
  • night sweats
  • fatigue
  • joint aches
  • red spotty rash
  • shortness of breath

This type of infection is commonly called Valley Fever.

If your body is not able to fight the infection on its own or your immune system is compromised, coccidioidomycosis can develop into a chronic infection. In this case the symptoms resemble tuberculosis and include:

  • cough
  • chest pain
  • fever
  • weight loss
  • lung nodules
  • blood in sputum
  • development of pneumonia

Disseminated coccidioidomycosis occurs when the infection has spread to other parts of the body from the lungs. The symptoms depend on where the infection spreads but can often include:

  • ulcers, skin lesions, or nodules that are more serious than a rash
  • lesions in bones including the skull or spine
  • painful and swollen joints, especially in the knees or ankles
  • meningitis, the most deadly complication

Let a doctor know if you have any of these symptoms and have recently traveled to or live in a high-risk area.

Diagnosing Disseminated Coccidioidomycosis

Your doctor will first take your medical history. You should let your doctor know if you have recently traveled to a high-risk area.

Your doctor will then perform one or more of the following tests:

X-Ray

Your doctor may order X-ray images of your lungs to look for infection or blockage.

Sputum Smear or Culture

Your doctor may use cotton ball or swab to take a sample of your sputum to test for the presence of the fungus.

Blood Tests

Your doctor might take a sample of your blood to see if your body has made antibodies against the fungus.

Biopsy

Your doctor may take a sample of your tissue or affected areas. This confirms if the fungus is in other parts of your body.

Treating Disseminated Coccidioidomycosis

It can take six months to a year to fully recover from the infection.

Rest and fluids give your body time to fight the infection, and you will usually fully recover. If the infection gets worse or spreads to other parts of your body you will be treated with antifungal agents (amphotericin B and fluconazole).

The infection can return after treatment if your immune system is weak. If this happens, your healthcare professional will monitor you and give you additional treatment until the infection is gone.

Potential Complications

If not treated, the complications from the infection can include:

  • severe pneumonia
  • ruptured lung nodules
  • meningitis
  • other complications ranging from skin lesions to heart problems depending on where the infection has spread

Complications from disseminated coccidioidomycosis can be severe, and can even be fatal. It is essential to seek treatment as soon as possible if you believe you might have this infection.

Preventing Disseminated Coccidioidomycosis

To avoid coming in contact with the fungus, you should take extra precaution around dust in high-risk area. Make sure to stay out of dust storms. If you have to go out on a windy, dusty day, wear a mask. Wet soil before digging or working outside, and close doors and windows to keep dust from getting in.

As the high-risk areas develop, the infection rate will decrease. This is due to the natural development of soil into paved roads and landscaping that will reduce the spread of the fungus.

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Article Sources:

  • Coccidioidomycosis. (2012, March 15). Centers for Disease Control and Prevention. Retrieved June 22, 2012, from http://www.cdc.gov/fungal/coccidioidomycosis/
  • Coccidioidomycosis. (June 2010). The Center for Food Security & Public Health and the Institute for International Cooperation in Animal Biologics. Iowa State University (ISU). Retrieved July 5, 2012, from http://www.cfsph.iastate.edu/Factsheets/pdfs/coccidioidomycosis.pdf
  • Coccidioides precipitin. (2011, June 9). U.S. National Library of Medicine, National Institutes of Health. Retrieved June 22, 2012, from http://www.nlm.nih.gov/medlineplus/ency/article/003525.htm
  • Galgiani, J. N., Ampel, N. M., Catanzaro, A., Johnson, R. H., Stevens, D. A., & Williams, P. L. (2000). Practice Guidelines for the Treatment of Coccidioidomycosis. Clinical Infectious Diseases, 30(4), 658-661.
  • Hospenthal, D. R., Struble, K., Oppenheimer, A. P., & Arsura, E. L. (2011, December 8). Coccidioidomycosis. Medscape: Medscape Access. Retrieved June 25, 2012, from http://emedicine.medscape.com/article/215978-overview
  • Increase in Coccidioidomycosis – California 2000-2007 (February 13, 20009). Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report. Retrieved July 5, 2012, from http://www.cdc.gov/mmwr/pdf/wk/mm5805.pdf
  • Kirkland, T. N., & Fierer, J. (1996). Coccidioidomycosis: A Reemerging Infectious Disease. Emerging Infectious Diseases, 3(2), 191-199.
  • Valley fever. (2010, March 13). Mayo Clinic. Retrieved June 25, 2012, from http://www.mayoclinic.com/health/valley-fever/DS00695

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