Coccidioidomycosis; chronic pulmonary Causes and Risks:
The infection is caused by breathing in the spores of a fungus in desert regions. The disease can have an acute , chronic , or disseminated form. The chronic form usually develops after a latent period of 20 years or more after initial infection which is usually benign and may go undiagnosed. Lung abscesses may form and may rupture into the pleural spaces causing empyema (pus in the pleural space). About 60% of infections cause no symptoms and are only recognized by a positive coccidioidin skin test . In the remaining 40% symptoms range from mild to severe. Dark skinned people and people with a weak immune system are more susceptible to infection. The incidence of chronic disease is 1 out of 100,000 people.
Prevention:
Avoiding travel to regions where this fungus is found may prevent risk of developing this disorder. For people living in those areas, prevention may not be possible (this is a rare disorder, so prevention is usually not a concern except for immunocompromised people).
Symptoms:
Additional symptoms that may be associated with this disease:
Signs and Tests:
Treatment:
Bedrest and supportive treatment, especially improved nutrition are important. Antifungal medications are prescribed to treat the infection. Amphotericin B is used for progressive disease or empyema . Ketoconazole may be useful but has not been fully evaluated for this condition. Fluconazole or itraconazol are other antifungal medications that are sometimes used.
Prognosis:
With treatment The outcome is usually good although relapses may occur.
Complications:
Call Your Healthcare Provider:
Call for an appointment with your health care provider if coccidioidomycosis symptoms worsen or do not improve with treatment.
Call your health care provider if new symptoms develop.
This chest X-ray shows the affects of the fungal infection, coccidioidomycosis. In the middle of the left lung (seen on the right side of the picture) there are multiple, thin-walled cavities (seen as light areas) with a diameter of 2 to 4 centimeters. To the side of these light areas are patchy light areas with irregular and poorly defined borders. Diseases that may explain these X-ray findings include lung abscesses, chronic pulmonary coccidioidomycosis, chronic pulmonary tuberculosis, chronic pulmonary histoplasmosis, and others.
Tuberculosis is an infectious disease that causes inflammation, the formation of tubercules and other growths within tissue, and can cause tissue death. These chest X-rays show advanced pulmonary tuberculosis. There are multiple light areas (opacities) of varying size that run together (coalesce). Arrows indicate the location of cavities within these light areas. The X-ray on the left clearly shows that the opacities are located in the upper area of the lungs toward the back. The appearance is typical for chronic pulmonary tuberculosis but may also occur with chronic pulmonary histiocytosis and chronic pulmonary
coccidioidomycosis. Pulmonary tuberculosis is making a comeback with new resistant strains that are difficult to treat. Pulmonary tuberculosis is the most common form of the disease, but other organs can be infected.
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