| Disease/Syndrome |
Coccidioidomycosis |
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| Category |
Infection, Occupational |
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| Acute/Chronic |
Subacute |
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| Synonyms |
Valley fever; San Joaquin fever; Desert fever; Coccidioidal granuloma; Coccidiioides immitis infection |
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| Biomedical References |
Search PubMed |
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| Comments |
Coccidioidomycosis usually begins with a flu-like respiratory illness. Erythema nodosum develops in about one fifth of clinically recognized cases. Primary infection 1) heals completely; 2) leaves residual fibrosis and a pulmonary nodule (sometimes calcified); or, 3) progresses (in about 1 in a 1000 symptomatic cases) to the disseminated form of the disease: abscesses in all parts of body including skin, bone, and brain. Handling mold cultures in the laboratory is extremely hazardous. Because of occupational exposure, males are more frequently affected than females. Coccidioidomycosis is not directly transmitted from animal to human or from human to human. There is a high prevalence of positive reactors in endemic areas. Recovery is usually followed by lifelong immunity, but reactivation can occur in those who become immunosuppressed therapeutically or by HIV infection. Negative reactors should not be recruited to endemic areas for road building or other dusty occupations. [CCDM, p. 121-3] Leukocytosis is a common finding. [Wallach, p. 994] Nonspecific rashes, as well as erythema nodosum and erythema multiforme, may appear at the time of the primary infection. Patients may have arthralgias, "desert rheumatism," at this time. Primary lung infection may progress to pneumonia, pleural and pericardial effusions, hemoptysis, and pulmonary nodules. Disseminated infection usually occurs within six months of the primary infection. Manifestations of disseminated infection include verrucous skin lesions, cerebral abscesses, infectious arthritis, lymphadenitis, kidney infection, chorioretinitis, liver abscesses, epididymo-orchitis, and infections of the uterus, tubes, and ovaries. [ID, p. 2231-4] Calculations predict that there are 150,000 new cases annually in the heavily populated areas of southern Arizona and southern central California. About 1/2 to 2/3 of patients are mildly infected and do not seek medical attention. Most infections are self-limited and without sequelae. The most commonly diagnosed syndromes in normal hosts are: 1.) Early respiratory infection; 2.) Pulmonary nodules and cavities, and; 3.) Extrapulmonary dissemination (0.5% of all infected people). Immunocompromised patients are at increased risk for dissemination. Many patients with extrapulmonary dissemination have normal chest x-rays. Disseminated disease occurs most commonly in the skin, the bones and joints, and in the meninges. [PPID, p. 3040-9] |
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| Latency/Incubation |
1 week to 1 month |
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| Diagnostic |
Stain; Culture (hazardous); Serology; Skin test for epidemiology studies; [ID, p. 2235-7; Wallach, p. 994] IgM antibodies are found in the early stages of the disease. [Current Consult, p. 242] |
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| ICD-9 Code |
114 |
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| Effective Antimicrobics |
Yes |
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| Scope |
Arid regions of Western hemisphere |
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| Reference Link |
CDC - Coccidioidomycosis |
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| X-Ray |
MedlinePlus Medical Encyclopedia: Coccidioidomycosis - chest X-ray |
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| Related Information in Haz-Map |
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| Symptoms/Findings |
Symptoms/Findings associated with this disease:
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| Job Tasks |
High risk job tasks associated with this disease:
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