Skin Lesion of Coccidioidomycosis

Written by Mary Ellen Ellis | Published on August 7, 2012
Medically Reviewed by George Krucik, MD

What are Skin Lesions of Coccidioidomycosis?

Skin lesions of coccidioidomycosis occur in conjunction with the fungal infection of the same name. Known more commonly as “valley fever,” the infection is caused by a fungus called Coccidioides immitis. It is most commonly contracted in desert regions in the southwestern United States, and in Central and South America. Skin lesions are a sign of widespread (disseminated) fungal disease

The infection begins in the lungs, but can travel to other parts of the body. When the fungus affects the skin, it causes rashes and lesions. The skin lesions early in the disease are thought to be caused by an immune response to the infection, rather than by the fungus itself.

In the early stage of infection, the lesions are minor rashes that clear up without treatment. When the infection has spread further the skin lesions become severe and may include pus-filled abscesses.

The outlook for recovery is good if you’re otherwise healthy. The condition may be life-threatening for those who have a compromised immune system or advanced stages of the infection. This infection is treated with antifungal medications.

Infection by Coccidioides immitis

Lesions are one of many possible symptoms of infection by coccidioides fungi. Infections are contracted mostly in the deserts of the southwestern United States. You can get the infection by inhaling the spores of the fungus. Early infection may cause mild or severe symptoms, similar to those of the flu. These may include:

  • fever
  • headache
  • joint pain
  • muscle ache
  • rash

In many people, no symptoms are seen.

Some people will recover from the infection with no treatment. Others will develop very severe and life-threatening infections.

The Stages of Valley Fever-Related Skin Lesions

If you contract valley fever, you may experience lesions or rashes as a symptom. There are two stages of the disease. You may experience only the first stage and recover before reaching the more serious second stage.

Primary Infection

During the initial infection of your lungs by the fungus, you may experience skin lesions. These can include erythema nodosum or erythema multiforme. These types of skin rashes are usually not serious. They often go away on their own.

The rashes that appear during primary infection are most likely caused by your immune system reacting to the fungal infection. They are not caused by the fungus itself.

Disseminated Infection

In the second stage of valley fever, the infection has spread from your lungs to other parts of your body, including the skin. Dissemination of the infection can be very serious. The lesions that you may experience during this second stage of infection are much more severe. They can include ulcers, nodules, and abscesses.

These lesions will contain the fungus. They are evidence of a widespread infection.

Symptoms of Valley Fever-Related Skin Lesions

The rash in the primary stage of infection is like any other allergic or immune system rash. Your skin will be red, raised, itchy, and irritated.

In the disseminated stage of the infection, lesions are much more severe. You may experience any of the following lesion types:

  • papule: a raised spot on your skin that is solid and less than a centimeter across
  • nodule: the same as a papule, but larger than a centimeter in width
  • pustule: a pus-filled lesion that is inflamed and small in size
  • abscess: a larger, pus-filled lesion

Risk Factors for Valley Fever-Related Skin Lesions

Anyone living in a desert region can inhale fungal spores and get valley fever. Many healthy people who become infected will not experience any symptoms. Some may have mild symptoms that clear up before the infection becomes widespread.

If you have a weak immune system, you are more likely to experience progression of the disease to the disseminated stage.

Diagnosing Valley Fever

Because the symptoms of valley fever can be so varied from patient to patient, your doctor may not be able to diagnosis it on symptoms alone. To pinpoint the infection, you must have a test that identifies the Coccidioides immitis fungus in your body.

A blood test can detect antibodies specific to the fungus. Your doctor may also want to take a sample of your sputum, which is the secretion from your airways. If you are infected, the fungus will be seen in the sample.

Treatments for Skin Lesion Connected to Valley Fever

Antifungal medications are used for the skin lesions associated with coccidioidomycosis.

In the primary stage of infection, the lesions are likely to clear up without any treatment. Topical antifungals may be used to speed healing.

In the dissemination phase, treatment is necessary. Antifungal medication can be given topically, in an IV, or in pill form. If you have a suppressed or weakened immune system, you may need long-term treatment. You may also need antibiotics to treat any infections in the broken skin of the lesions.

Outlook for Valley Fever-Related Skin Lesions

The outlook for the lesions associated with valley fever depends upon the stage of infection and the state of your immune system. If you have a primary infection and are healthy, the outlook is excellent. Symptoms will usually disappear within two to six weeks. If you have a compromised immune system or a disseminated infection, recovery can take up to a year and is less certain. In rare cases, valley fever can be fatal.

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