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Coccidioidomycosis (Coccidioides immitis) (Valley Fever)
1995 Case Definition
Clinical description
Infection may be asymptomatic or may produce an acute
or chronic disease. Although the disease initially resembles an influenza-like
febrile illness primarily involving the bronchopulmonary system,
dissemination can occur to virtually any organ system. Confirmation
of coccidioidomycosis requires the demonstrated presence of C.immitis by
histopathologic, cultural, or molecular means; and/or demonstration
of a specific immunologic response (i.e., skin test conversion or
demonstration of presence of coccidioidal antibody). The results
of these immunologic tests must be interpreted in the context of
the varied clinical presentations and the duration and clinical type
of coccidioidomycosis.
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, by chest
X-ray
- 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
Laboratory-confirmed coccidioidomycosis requires one
or more of the following:
Cultural, histopathologic, or molecular
evidence of presence of C. immitis, or
- Immunologic evidence of infection
- Serologic (testing of serum, cerebrospinal
fluid, or other body fluid):
- Detection of coccidioidal IgM
by immunodiffusion, enzyme immunoassay (EIA), latex
agglutination, or tube precipitin, or
- Detection of rising titer of
coccidioidal IgG by immunodiffusion, EIA, or complement
fixation.
- Coccidioidal skin test conversion from negative
to positive after the onset of clinical signs and symptoms.
Case classification
Confirmed: a case that meets the clinical case definition
and is laboratory confirmed.
See also:
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