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| | __NOTOC__ |
| {{DiseaseDisorder infobox | | | {{DiseaseDisorder infobox | |
| Image = Coccidioidomycosis_01.jpg | | | Image = Coccidioidomycosis_01.jpg | |
| Caption = [[Histopathology|Histopathological]] changes in a case of coccidioidomycosis of the lung showing a large fibrocaseous nodule. | | | Caption = [[Histopathology|Histopathological]] changes in a case of coccidioidomycosis of the lung showing a large fibrocaseous nodule| |
| Name = Coccidioidomycosis | | | Name = Coccidioidomycosis | |
| ICD10 = {{ICD10|B|38||b|35}} |
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| ICD9 = {{ICD9|114}} |
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| MedlinePlus = 001322 |
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| eMedicineSubj = med |
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| eMedicineTopic = 103 |
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| eMedicine_mult = {{eMedicine2|ped|423}} |
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| MeshID = D003047 |
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| }} | | }} |
| {{Search infobox}} | | {{About1|Coccidioides immitis}} |
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| | {{Coccidioidomycosis}} |
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| '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
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| {{CMG}} | | {{CMG}}; {{AE}} {{RT}}; {{VB}}; {{ADG}} |
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| | {{SK}} ''Coccidioides'' infection; Posadas-Wernicke disease; Valley fever; San Joaquin fever, Desert fever |
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| ==Overview== | | ==[[Coccidioidomycosis overview|Overview]]== |
| '''Coccidioidomycosis''' (also known as '''Valley fever''', '''San Joaquin Valley Fever''', '''California valley fever''', '''desert fever,''' and (incorrectly) '''coccidiomycosis''') is a [[fungus|fungal]] disease caused by ''[[Coccidioides immitis]]'' or ''[[Coccidioides posadasii|C. posadasii]]''.<ref name=Baron>{{cite book | author = Walsh TJ, Dixon DM | title = Spectrum of Mycoses. ''In:'' Baron's Medical Microbiology ''(Baron S ''et al'', eds.)| edition = 4th ed. | publisher = Univ of Texas Medical Branch | year = 1996 | id = [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mmed.section.4006 (via NCBI Bookshelf)] ISBN 0-9631172-1-1 }}</ref> It is [[endemic (epidemiology)|endemic]] in certain parts of Arizona, California, Nevada, New Mexico, Texas, Utah and northwestern Mexico.<ref name=Hector_2005>{{cite journal | author = Hector R, Laniado-Laborin R | title = Coccidioidomycosis--a fungal disease of the Americas. | journal = PLoS Med | volume = 2 | issue = 1 | pages = e2 | year = 2005 | url = http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0020002| id=PMID 15696207}}</ref>
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| ''C. immitis'' resides in the soil in certain parts of the southwestern [[United States]], northern Mexico, and parts of Central and South America [http://www.mayoclinic.com/print/valley-fever/DS00695/DSECTION=all&METHOD=print]. It is dormant during long dry spells, then develops as a mold with long filaments that break off into airborne spores when the rains come. The spores, known as [[arthroconidia]], are swept into the air by disruption of the soil, such as during construction or farming. Infection is caused by inhalation of the particles. The disease is not transmitted from person to person. ''C. immitis'' is a dimorphic saprophytic organism that grows as a [[mycelium]] in the soil and produces a spherule form in the host organism.
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| The disease is usually mild, with flu-like symptoms and rashes, and the Mayo Clinic estimates that half the population in some affected areas have suffered from the disease. On occasion, those particularly susceptible, including pregnant women, people with weakened immune systems, and those of Asian, Hispanic and African descent, may develop a serious or even fatal illness from valley fever. Serious complications include severe [[pneumonia]], [[lung nodule]]s, and disseminated disease, where the fungus spreads throughout the body. The disseminated form of valley fever can devastate the body, causing skin ulcers and [[abscess]]es to bone lesions, severe joint pain, heart inflammation, [[urinary tract]] problems, [[meningitis]], and death.
| | ==[[Coccidioidomycosis historical perspective|Historical Perspective]]== |
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| It has been known to infect humans, dogs, cattle, livestock, llamas, apes, monkeys, kangaroos, wallabies, tigers, bears, badgers, otters and marine mammals. <ref>Valley Fever Center for Excellence | url = http://www.vfce.arizona.edu/VFID-other.htm</ref>
| | ==[[Coccidioidomycosis pathophysiology|Pathophysiology]]== |
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| Symptomatic infection (40% of cases) usually presents as an [[influenza]]-like illness with fever, cough, headaches, [[rash]], and [[myalgia]] (muscle pain).<ref name=Sherris>{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | pages = pp. 680-83 | publisher = McGraw Hill | year = 2004 | id = ISBN 0838585299 }}</ref> Some patients fail to recover and develop chronic pulmonary infection or widespread disseminated infection (affecting [[meninges]], soft tissues, joints, and bone). Severe pulmonary disease may develop in [[HIV]]-infected persons.<ref name=Ampel_2005>{{cite journal | author = Ampel N | title = Coccidioidomycosis in persons infected with HIV type 1. | journal = Clin Infect Dis | volume = 41 | issue = 8 | pages = 1174-8 | year = 2005 | id = PMID 16163637}}</ref> The disease can be fatal.
| | ==Causes== |
| | [[Coccidioides immitis|Coccidioides Immitis]] | [[Coccidioides posadasii|Coccidioides Posadasii]] |
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| [[Image:Geographic_Distribution_of_Coccidioidomycosis_02.png|left|thumb|300px|Geographic distribution of coccidioidomycosis.]] | | ==[[Coccidioidomycosis differential diagnosis|Differentiating Coccidioidomycosis from other Diseases]]== |
| ==Occurrence==
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| California state prisons have been particularly affected by Coccidioidomycosis, as far back as 1919. In 2005 and 2006, the Pleasant Valley State Prison near Coalinga and Avenal State Prison near Avenal on the western side of the San Joaquin Valley had the highest incidence rate in 2005, of at least 3,000 per 100,000 [http://www.blackwell-synergy.com/doi/abs/10.1196/annals.1406.011].
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| ==Biological Warfare== | | ==[[Coccidioidomycosis epidemiology and demographics|Epidemiology and Demographics]]== |
| ''C. immitis'' was investigated by the United States during the 1950s and 1960s as a potential biological weapon. The Cash strain received the military symbol OC, and original hopes were for its use as an incapacitant. As medical epidemiology later made clear, OC would have lethal effects on several segments of the population, so it was later considered a lethal agent. It was never standardized, and beyond a few field trials, it was never weaponized. Most military work on OC was on vaccines by the mid-1960s.
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| ==Diagnostic test== | | ==[[Coccidioidomycosis risk factors|Risk Factors]]== |
| The fungal infection can be demonstrated by microscopic detection of diagnostic cells in body fluids, exudates, [[sputum]] and [[biopsy]]-tissue. With specific [[nucleotide]] primers ''C.immitis'' [[DNA]] can be amplified by [[PCR]]. It can also be detected in culture by morphological identification or by using molecular probes that hybridize with ''C.immitis'' [[RNA]]. An indirect demonstration of fungal infection can be achieved also by serologic analysis detecting fungal [[antigen]] or host [[antibody]] produced against the fungus.
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| ==Pathology== | | ==[[Coccidioidomycosis screening|Screening]]== |
| <youtube v=RtpvzCfFwfg/>
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| ==Popular culture== | | ==[[Coccidioidomycosis natural history|Natural History, Complications and Prognosis]]== |
| The illness is mentioned in episode Lines in the Sand of the TV Show ''House'', as the cause of a young girl's loss of inhibition. The illness does not actually cause loss of inhibition, nor does it cause milky tears. This was not a factual error in the episode: House was tricking the girl, however this was not obvious to many viewers.
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| It is also the center of an episode of the TV series Bones, ''The Man In the Fallout Shelter''. After being exposed to the fungus, the team was quarantined over Christmas to determine whether or not they had become infected. It was erroneously claimed to be contagious from person to person.
| | ==Diagnosis== |
| | [[Coccidioidomycosis history and symptoms|History and Symptoms]] | [[Coccidioidomycosis physical examination|Physical Examination]] | [[Coccidioidomycosis laboratory tests|Laboratory Findings]] | [[Coccidioidomycosis chest x ray|Chest X Ray]] | [[Coccidioidomycosis CT|CT]] | [[Coccidioidomycosis MRI|MRI]] |
| | ==Treatment== |
| | [[Coccidioidomycosis medical therapy|Medical Therapy]] | [[Coccidioidomycosis primary prevention|Primary Prevention]] | [[Coccidioidomycosis secondary prevention|Secondary Prevention]] | [[Coccidioidomycosis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Coccidioidomycosis future or investigational therapies|Future or Investigational Therapies]] |
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| ==References== | | ==Case Study== |
| {{Reflist|2}}
| | [[Coccidioidomycosis case study one|Case #1]] |
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| ==External links== | | ==External Links== |
| * [http://www.cdc.gov/ncidod/dbmd/diseaseinfo/coccidioidomycosis_t.htm U.S. Centers for Disease Control and Prevention page on Coccidioidomycosis] | | * [http://www.cdc.gov/fungal/coccidioidomycosis/ U.S. Centers for Disease Control and Prevention page on Coccidioidomycosis] |
| * [http://www.nlm.nih.gov/medlineplus/ency/article/001322.htm Medline Plus Entry for Coccidioidomycosis] | | * [http://www.nlm.nih.gov/medlineplus/ency/article/001322.htm Medline Plus Entry for Coccidioidomycosis] |
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| {{Mycoses}} | | {{Mycoses}} |
| {{SIB}}
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| [[Category:Fungal diseases]]
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| [[de:Kokzidioidomykose]] | | [[de:Kokzidioidomykose]] |
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