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Coccidioidomycosis (Coccidioides spp., Valley fever)
2008 Case Definition
Clinical Description
Infection may be asymptomatic or may produce an acute or chronic disease. Although the disease initially resembles an influenza-like or pneumonia-like febrile illness primarily involving the bronchopulmonary system, dissemination can occur to multiple organ systems.
Clinical case definition
An illness characterized by one or more of the
following:
- Influenza-like signs and symptoms (e.g., fever,
chest pain, cough, myalgia, arthralgia, and headache)
- Pneumonia or other pulmonary lesion, diagnosed
by chest radiograph
- Erythema nodosum or erythema multiforme rash
- Involvement of bones, joints, or skin by dissemination
- Meningitis
- Involvement of viscera and lymph nodes
Laboratory Criteria for Diagnosis
A confirmed case must meet at least one of the following laboratory criteria for diagnosis:
- Cultural, histopathologic, or molecular evidence
of presence of Coccidioides species, or
- Positive serologic test for coccidioidal antibodies
in serum, cerebrospinal fluid, or other body fluids by:
- Detection of coccidioidal immunoglobulin M (IgM) by
immunodiffusion, enzyme immunoassay (EIA), latex agglutination,
or tube precipitin, or
- Detection of coccidioidal immunoglobulin G (IgG) by immunodiffusion,
EIA, or complement fixation, or
- Coccidioidal skin-test conversion from negative
to positive after onset of clinical signs and symptoms
Case Classification
Confirmed: A case that meets the clinical case definition and is laboratory confirmed.
References:
- Pappagianis D, Zimmer BL. Serology of coccidioidomycosis. Clin Microbiol Rev 1990 Jul;3(3):247-68.
- Chiller TM, Galgiani JN, Stevens DA. Coccidioidomycosis. Infect Dis Clin North Am 2003 Mar;17(1):41-57, viii.
- Valdivia L, Nix D, Wright M, et al. Coccidioidomycosis as a common cause of community acquired pneumonia. Emerg Infect Dis 2006 Jun;12(6):958-62.
- Saubolle MA. Laboratory Aspects in the Diagnosis of Coccidioidomycosis. Ann N Y Acad Sci 2007 Mar 15.
See also:
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