What is Coccidioidomycosis?
It refers to an infection caused by Coccidioides immitis fungal spores. It is also known by other names like Valley fever and San Joaquin Valley fever.
As aforesaid, it is a type of fungal infection. It is caused due to breathing in of the Coccidioides immitis fungal spores which are frequently encountered in desert areas. This fungus grows in soil. It can be dispersed by wind into the air. Inhalation of these spores can give rise to infection in the lungs.
Who Gets Coccidioidomycosis?
People who work in outdoor environment close to soil infected with fungus, such as farmers and construction workers, are the ones who are particularly susceptible to this condition. They are most likely to come into contact with spores of the fungus Coccidioides immitis.
Coccidioidomycosis Risk Factors
Travelling to desert areas or places where the fungus resides can enhance the risk for contracting this infection. An individual belonging to African, Philippinese or Native American descent may also develop a serious infection. A person can also have this disorder if he or she has a weakened immune system due to conditions like diabetes, AIDS or drugs that make the immune system subdued.
Individuals with a healthy immune system may not suffer from any symptoms of Coccidioidomycosis fungal infection. A strong, actively functional immunity can help combat infection successfully even before it produces any symptoms.
However, individuals with a weak immunity may experience difficulties similar to cold, flu or pneumonia. These may arise 5-21 days after exposure to fungus. Symptoms arise only in rare cases of this disorder.
Some of the main signs of this disease are
- Chest pain, which can vary from moderate to acute
- Alterations in mental condition
- Cough, which may produce blood in some cases
- Joint pain and stiffness
- Lack of appetite
- Stiffness of neck
- Muscular pain
- Sweats during night
- Erythema Nodosum (A condition marked by development of red, painful mass on lower legs)
- Light sensitivity
- Loss of weight
In some cases, there may be some other signs like inflammation of joints, swelling of the feet or ankle, Increase in size of lymph nodes and their draining. This disorder may also involve development of itchy rashes in one or more areas of the skin surface. The infection originates in the lungs and may spread to other parts of the human body.
The condition is diagnosed with the aid of a number of medical tests. Some common medical examinations used for Coccidioidomycosis testing involve
- Bronchoscopy along with lavage (Cleaning a hollow organ like stomach with a flush of water)
- Blood test, which helps detect presence of fungus in bloodstream
- Chest x-ray
- Lung biopsy or Lymph node biopsy
- Complete blood count (CBC) with differential
- Sputum culture
- Sputum smear (KOH test)
This condition does not have any exact treatment. Individuals with healthy immunity may not experience any symptoms. Treatment is generally unnecessary in such cases. The disease goes away without cure in almost all cases.
If symptoms arise in individuals, bed rest is required to provide the immune system with time to resolve the infection. Moderate cases of Primary Coccidioidomycosis need only bed rest and in some cases, cure of flu-like symptoms until fever disappears. Severe cases that arise along with dissemination need long-term I.V. infusion along with injection of amphotericin B into the spinal canal. In some cases, drainage or excision of lesions may be done. Acute pulmonary lesions may need Lobectomy.
Medicines are rarely used for treating this condition. If and when used, the aim of medication is to control the discomforting symptoms. Ketoconazole and Miconazole help in suppressing the symptoms. However, they are ineffective in completely eradicating the disease. Itraconazole is successful in curing early stages of severe cases. Amphotericin B, fluconazole and itraconazole are also effective in addressing severe cases along with dissemination.
If an individual suffering from STD syndromes like AIDS or HIV has this condition, close monitoring by an experienced healthcare professional is required to make sure that the infection does not spread or become fatal.
In rare circumstances, the immune system may be unable to clear up the infection. The fungal infection may get distributed to other parts of the body from the lungs. Apart from lungs, some of the other areas that are commonly affected involve
In complicated cases, the infection may lead to firm, swollen joints apart from injuries on the bones and the skull surface. It may also result in unusual projections beneath the skin surface. The infection may also give rise to Meningitis in the most serious circumstances. Meningitis is an infection that arises in the protective tissues in the spine and the brain and may even lead to death in rare cases.
The prognosis of this disease depends on the overall health of sufferers and the form of the condition that they have. In acute cases, the prognosis is likely to be proper. The outcome is usually good with cure, for severe or chronic cases of the disease. However, relapses can occur in some cases. People with disseminated disease have a high death rate.
In patients with weakened immunity, Disseminated Coccidioidomycosis may occur. It is an acute complication that is likely if immunity gets weakened due to
- Anti-tumor necrosis factor (TNF) therapy
- Pregnancy (especially the first trimester)
- Glucocorticoid medications (prednisone)
- Organ transplants (and associated medicates)
- Heart-lung (cardiopulmonary) conditions
Other complications like Pleural effusion and relapse of infection may also occur in some cases. Complications may also arise from use of medicines applied to cure this infection. Such discomforts may involve side effects like chills, nausea and fever.
One can avoid getting this condition by maintaining good health. A robust health will help keep the disease only in benign pulmonary form. Preventing AIDS by keeping sexual partners to minimum or practicing safe sexual habits can help you avoid damages to the immune system and help avoid this condition as well as its later complications.
This fungal infection is most frequently seen in people residing in the desert regions of South America, Central America and the south-western part of the United States.
There are three types of Coccidioidomycosis. These are
Acute Pulmonary Coccidioidomycosis
This is mainly a mild form which leads to only a few or almost no symptoms. The incubation period, or the time between inhalation of the spores and getting sick, varies from 7 to 21 days. This condition can go away without cure.
Chronic Pulmonary Coccidioidomycosis
It is a very complicated fungal infection that may develop 20 years or more after initial infection. Lung abscesses or Infections can develop and rupture, letting out pus (empyema) in the space between the ribs and the lungs (pleural space).
This is a widespread variation of the condition in which infection may spread to other areas of the body such as the brain, skin, heart and bones. Meningitis arises in approximately half of all sufferers of Disseminated Occidioidomycosis.
If you have symptoms of this disease or if your health does not improve with treatment, you should immediately get in touch with a professional health care provider. Early treatment will help you get rid of this condition sooner and also avoid later complications.