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Pulmonary Coccidioidomycosis (Valley Fever)

What is pulmonary coccidioidomycosis?

Pulmonary coccidioidomycosis is an infection in the lungs 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.

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Types

Types of valley fever

There are two types of valley fever: acute and chronic.

Acute

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. Occasionally, it can disseminate into the body, causing infections in the skin, bone, heart, and central nervous system. These infections will require treatment.

Chronic

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 many as 20 years or more after the initial illness. In one form of the illness, lung abscesses (infections) can form. When the abscesses rupture, they release 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.

Symptoms

What are the symptoms of valley fever?

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:

  • cough
  • loss of appetite
  • fever
  • 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
  • wheezing
  • chest pain
  • muscle aches
  • headache
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Diagnosis

How is valley fever diagnosed?

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

Treatment

How is valley fever treated?

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 go away.

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:

Rarely, for chronic valley fever, surgery is required to remove the infected or damaged parts of your lungs.

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Doctor’s visit

When to see a doctor

You should see your doctor if you’re displaying symptoms of valley fever. You should also visit your doctor if your symptoms don’t go away with treatment or if you develop new symptoms.

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Risk factors

Who is most at risk?

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
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Transmission

Is valley fever contagious?

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.

Outlook

Long-term outlook

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’s roughly 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. Disseminated valley fever is often fatal and requires immediate medical attention.

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Prevention

Should you avoid travel to areas where valley fever fungus exists?

Because the illness is usually not serious, most people don’t 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’re more likely to develop the disseminated form of the illness.

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