|
Coccidioidomycosis; disseminated Causes and Risks:
This is caused by breathing in the spores of a fungus in desert regions. About 60% of acute infections cause no symptoms and are only recognized by a positive coccidioidin skin test . In the remaining 40% symptoms range from mild to severe. In disseminated disease, extension of infection to the bones, lungs, liver,
meninges, brain, skin, heart, and pericardium (sac around the heart) may take place. Meningitis occurs in 30 to 50% of cases of disseminated disease. Progressive disease is more common in blacks, Filipinos and Mexicans. Immunodeficient ( immunosuppressed ) people, including those with HIV infection , and pregnant women of any race are more prone to dissemination. Recent travel to or residence in southwestern deserts of U.S. is a risk factor. The incidence of disseminated disease is 1 out of 1,000,000 people.
Prevention:
General maintenance of good health will limit the disease to a benign pulmonary form. Prevention of AIDS or other causes of damaged immune system will generally prevent the more severe forms of the disease.
Symptoms:
Additional symptoms that may be associated with this disease:
Signs and Tests:
Treatment:
Bedrest and supportive treatment, especially improved nutrition, are indicated. Antifungal medications are prescribed to treat the infection. Amphotericin B is given intravenously over several weeks. In meningitis , intrathecal therapy (delivered into the spinal column) is necessary. Ketoconazole may be used for disease that does not involve the
meninges. Fluconazole or itraconazol are other antifungal medications that may be used.
Prognosis:
People with disseminated disease have a high death rate. The course may be rapid for immunosuppressed patients.
Complications:
This can be a fatal disorder.
Call Your Healthcare Provider:
Call for an appointment with your health care provider if symptoms of disseminated coccidioidomycosis develop.
|