Coccidioidomycosis overview
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Coccidioidomycosis (also known as Valley fever, San Joaquin Valley Fever, California valley fever, desert fever, and (incorrectly) coccidiomycosis) is a fungal disease caused by Coccidioides immitis or C. posadasii.[1] It is endemic in certain parts of Arizona, California, Nevada, New Mexico, Texas, Utah and northwestern Mexico.[2] C. immitis resides in the soil in certain parts of the southwestern United States, northern Mexico, and parts of Central and South America [2]. 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.
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 nodules, and disseminated disease, where the fungus spreads throughout the body. The disseminated form of valley fever can devastate the body, causing skin ulcers and abscesses to bone lesions, severe joint pain, heart inflammation, urinary tract problems, meningitis, and death.
It has been known to infect humans, dogs, cattle, livestock, llamas, apes, monkeys, kangaroos, wallabies, tigers, bears, badgers, otters and marine mammals. [3]
Symptomatic infection (40% of cases) usually presents as an influenza-like illness with fever, cough, headaches, rash, and myalgia (muscle pain).[4] 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.[5] The disease can be fatal.
Popular culture
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.
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.
References
- ↑ Walsh TJ, Dixon DM (1996). Spectrum of Mycoses. In: Baron's Medical Microbiology (Baron S et al, eds.) (4th ed. ed.). Univ of Texas Medical Branch. (via NCBI Bookshelf) ISBN 0-9631172-1-1.
- ↑ Hector R, Laniado-Laborin R (2005). "Coccidioidomycosis--a fungal disease of the Americas". PLoS Med. 2 (1): e2. PMID 15696207.
- ↑ Valley Fever Center for Excellence | url = http://www.vfce.arizona.edu/VFID-other.htm
- ↑ Ryan KJ; Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. pp. pp. 680-83. ISBN 0838585299.
- ↑ Ampel N (2005). "Coccidioidomycosis in persons infected with HIV type 1". Clin Infect Dis. 41 (8): 1174–8. PMID 16163637.