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Coccidioides is a fungal infection caused by Coccidioides posadasii and Coccidioides immitis, which are common in South and Central America, Mexico, and the southwestern United States. The infection is spread through airborne spores and is a danger in certain occupations. Symptoms include fever, cough, chest pain, and fatigue. Treatment involves antifungal drugs. Disseminated disease is rare but can be fatal.
Coccidioides is an infection caused by two similar fungal species called Coccidioides posadasii and Coccidioides immitis. These fungi are common in South America, Central America, Mexico, and drier regions of the southwestern United States. The fungi are endemic to these places, meaning they are considered a native species and infection is a common occurrence. The disease caused by these fungi is often given a different name depending on the geographical location where the infection occurs; for example, it has been called valley fever, desert fever, San Joaquin fever, and California fever.
The regions where these fungi are most common are similar in terms of climate and geology, with low rainfall; hot summers; mild winters; sandy, salty, alkaline soil; and low altitude. These conditions provide ideal growing conditions for fungi and help the organism to spread. One of the main ways the organism spreads in the environment and infects humans is by becoming airborne. In arid climates, the likelihood of inhaling C. posadasii and C. immitis increases because the soil is drier and the fungi are more likely to become airborne.
In regions where the fungi are endemic, coccidioides infection is a danger in certain occupations, including construction and agriculture. The main risk factor for infection is outdoor activities in endemic regions. Although most cases of infection occur in endemic areas, it is possible for fungal contamination to cause infection outside these locations.
C. posadasii and C. immitis cause disease when inhaled into the lungs. Fungal infection causes large numbers of granule immune cells to be recruited to the site, leading to acute inflammation. In this stage, symptoms of coccidioid include chills, fever, cough, chest pain, fatigue, difficulty breathing, night sweats, headache, loss of appetite, weight loss, and body aches.
If the infection does not clear up in the acute phase, granulomas can form in the lungs. A granuloma is a group of immune cells that have surrounded an infectious organism. The immune system reacts this way in an attempt to stem the infection and prevent it from spreading. Chronic infection can cause fever, difficulty breathing, and coughing up blood.
Granulomas are characteristic of chronic inflammation, a condition that can lead to disseminated disease. This type of disease occurs when organisms enter other parts of the body, often through the bloodstream. People with disseminated disease are at high risk for meningitis and other types of systemic infection. Disseminated disease is rare but is often fatal due to the possibility of meningitis or multiple organ involvement.
Standard treatment of coccidioids involves the use of antifungal drugs to kill the invading organisms. Most infections resolve on their own without the use of drugs, but people with severe acute symptoms usually receive drugs to prevent the development of chronic or disseminated disease. People at increased risk of disseminated disease — such as the very young or old, people with reduced immune system function, or those with diabetes — typically receive medication, even for a mild infection.
