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Coccidioidomycosis, also known as Valley fever, is a fungal infection caused by Coccidioides. Symptoms typically include cough, fever, shortness of breath, headache, rash, and muscle pain. Onset is typically 1 to 3 weeks after exposure.[1]On the whole, oral fluconazole and intravenous amphotericin B are used in progressive or disseminated disease, or in immunocompromised individuals.[2]


In terms of the signs and symptoms we find that most infections are asymptomatic ; however when symptoms are present we find cough, fever, shortness of breath , headache, rash and chest pain .[3]


Complications may occur in individuals who have weakened immune systems, including severe pneumonia with respiratory failure and bronchopleural fistulas, lung nodules, and possible disseminated form, where the infection spreads throughout the body.[4]


Coccidioides is a genus of dimorphic ascomycetes in the family Onygenaceae. Member species are the cause of coccidioidomycosis, also known as San Joaquin Valley fever.[5]


Coccidioidomycosis diagnosis relies on a combination of an infected person's signs and symptoms, findings on radiographic imaging, biopsy as well as laboratory results.[6]

Differential diagnosis

In terms of the differential diagnosis of Coccidioidomycosis we find the following:Acute respiratory distress syndrome, Eosinophilic pneumonia, histoplasmosis and lung cancer among others.[7]


In management of an infected individual oral fluconazole and intravenous amphotericin B are used in progressive or disseminated disease, or in immunocompromised individuals. Amphotericin B used to be the only available treatment,[8][2] now there are alternatives, including itraconazole or ketoconazole, that may be used for milder disease.[9]


In the United States, C. Immitis is endemic to southern and central California with the highest presence in the San Joaquin Valley. C. posadassi is most prevalent in Arizona, although it can be found in a wider region spanning from Utah, New Mexico, Texas, and Nevada. An estimated 150 thousand infections occur annually.[10]


The first case of what was later named coccidioidomycosis was described in 1892 in Buenos Aires by Alejandro Posadas, a medical intern at the Hospital de Clínicas "José de San Martín".[11] Posadas established the infectious character of the disease after being able to transfer it in laboratory conditions to lab animals.[12]


  1. "Symptoms of Valley Fever | Coccidioidomycosis | Types of Fungal Diseases | Fungal | CDC". 13 January 2021. Archived from the original on 6 June 2020. Retrieved 22 December 2022.
  2. 2.0 2.1 Welsh O.; Vera-Cabrera L.; Rendon A. (November–December 2012). "Coccidioidomycosis". Clinics in Dermatology. 30 (6): 573–591. doi:10.1016/j.clindermatol.2012.01.003. PMID 23068145.
  3. Akram, Sami M.; Koirala, Janak (2024). "Coccidioidomycosis". StatPearls. StatPearls Publishing.
  4. Twarog, Meryl; Thompson, George (2015-09-23). "Coccidioidomycosis: Recent Updates". Seminars in Respiratory and Critical Care Medicine. 36 (5): 746–755. doi:10.1055/s-0035-1562900. PMID 26398540. Archived from the original on 2020-06-13. Retrieved 2021-06-02.
  5. "Coccidioidomycosis (Valley Fever)". Centers for Disease Control and Prevention (CDC). Archived from the original on 9 July 2013. Retrieved 11 July 2013.
  6. Malo J, Luraschi-Monjagatta C, Wolk DM, Thompson R, Hage CA, Knox KS (February 2014). "Update on the diagnosis of pulmonary coccidioidomycosis". Annals of the American Thoracic Society. 11 (2): 243–53. doi:10.1513/AnnalsATS.201308-286FR. PMID 24575994.
  7. Akram, Sami M.; Koirala, Janak (2024). "Coccidioidomycosis". StatPearls. StatPearls Publishing.
  8. Hector, Richard F.; Rutherford, George W.; Tsang, Clarisse A.; Erhart, Laura M.; McCotter, Orion; Anderson, Shoana M.; Komatsu, Kenneth; Tabnak, Farzaneh; Vugia, Duc J. (2011-04-01). "The Public Health Impact of Coccidioidomycosis in Arizona and California". International Journal of Environmental Research and Public Health. 8 (4): 1150–1173. doi:10.3390/ijerph8041150. ISSN 1661-7827. PMC 3118883. PMID 21695034.
  9. Barron MA, Madinger NE (November 18, 2008). "Opportunistic Fungal Infections, Part 3: Cryptococcosis, Histoplasmosis, Coccidioidomycosis, and Emerging Mould Infections". Infections in Medicine. Archived from the original on March 14, 2010. Retrieved June 2, 2021.
  10. Hospenthal, Duane. "Coccidioidomycosis". Medscape. Archived from the original on 2015-10-22. Retrieved 2015-10-18.
  11. Posadas A. Un nuevo caso de micosis fungoidea con posrospemias. Annales Cir. Med. Argent. (1892), Volume 15, p. 585-597.
  12. Hirschmann, Jan V. (2007). "The Early History of Coccidioidomycosis: 1892–1945". Clinical Infectious Diseases. 44 (9): 1202–1207. doi:10.1086/513202. PMID 17407039.