|
Coccidioidomycosis Causes and Risks:
Infection is caused by breathing in spores of the fungus, Coccidioides immitis, found in desert regions. 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 compromised immune system tend to have more serious infections. Individuals with AIDS are at high risk not only for pulmonary coccidioidomycosis but for the disseminated form and cutaneous form of the disease.
The disease can have an acute , chronic , or disseminated form. Acute pulmonary coccidioidomycosis is almost always mild, with few or no symptoms, and resolves without treatment. The incubation period is 10 to 30 days. The incidence of acute coccidioidomycosis is 1 out of 100,000 people.
Chronic pulmonary coccidioidomycosis can develop 20 or more years after initial infection which may not have been recognized, diagnosed, or treated. Infections (lung abscesses ) can form and rupture releasing pus ( empyema ) between the lungs and ribs (pleural space). The incidence of chronic disease is 1 out of 100,000 people.
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. The course of the disease may be rapid for immunosuppressed patients.
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:
Any of the following may be symptoms: Additional symptoms that may be associated with this disease: See also Skin lesion of coccidioidomycosis .
Signs and Tests:
Treatment:
The acute disease almost always goes away without treatment. Bedrest and treatment of flu-like symptoms until fever disappears may be recommended.
Prognosis:
The outcome in limited disease is likely to be good. With treatment, the outcome is usually good although relapses may occur. People with disseminated disease have a high death rate.
Complications:
- pleural effusion
- relapse of infection
- spread of the infection throughout the body
Call Your Healthcare Provider:
Call for an appointment with your health care provider if symptoms develop that are suggestive of coccidioidomycosis.
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.
This X-ray shows a single lesion (pulmonary nodule) in the upper right lung (seen as a light area on the left side of the picture). The nodule has distinct borders (well-defined) and is uniform in density. Tuberculosis (TB) and other diseases can cause this type of lesion.
Erythema nodosum consists of red to reddish purple hard (indurated) nodules which are painful to the slightest touch. These are most commonly seen on the shins (as pictured), but may occur on the thighs or elsewhere. They often occur in association with a group of widely varied diseases such as tuberculosis (TB), sarcoidosis, coccidioidomycosis, SLE, other fungal infections, and some drugs.
Erythema nodosum usually occurs in association with specific infections, inflammatory conditions, or medications. It consists of painful, hot, red skin lumps, usually over the shins. People with erythema nodosum should be evaluated for other disease processes.
Coccidioidomycosis is most commonly a lung infection, but it can also infect the skin. Cutaneous coccidioidomycosis on the forehead is pictured here. This occurs more frequently in warmer climates, including California and the Southwestern United States.
|
