Coccidioidomycosis
GENERAL PRINCIPLES
Coccidioides immitis is a dimorphic fungus that is endemic to the Southwestern US and Central America.
Disease is usually a self-limited pulmonary syndrome, responsible for up to 25% of all CAP in endemic regions.
Less common manifestations are chronic pulmonary illness and disseminated disease, which can affect the meninges, bones, joints, and skin. Risk factors for development of severe or disseminated disease include immunocompromising conditions, African or Filipino ancestry, diabetes, and pregnancy.DIAGNOSIS
Diagnosis requires culture, histopathology, or positive CF serology.
Serum CF titer of 1:16 or greater suggests extrathoracic dissemination.
LP should be performed for culture and CF serology, to rule out CNS involvement in persons with worsening, or persistent headache, altered mental status, unexplained nausea or vomiting, or new focal neurologic deficit.36
Skin testing should only be used for epidemiologic purposes to evaluate exposure.
TREATMENT
See Table 14-13.
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More on the topic Coccidioidomycosis:
- COCCIDIOIDOMYCOSIS
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