Every year, an estimated 150,000 people are infected with coccidioidomycosis, originally nicknamed San Joaquin Valley fever, and about 160 die, note updated guidelines by IDSA on Valley fever, published in Clinical Infectious Diseases. Valley fever is endemic in desert regions ranging from western Texas, Arizona and northern Mexico to the central San Joaquin Valley in California, as well as an area in south central Washington State. Some areas in Central and South America harbor the fungi as well.
The fungi that cause the infection – Coccidioides immitis and Coccidioides posadasii – live in desert soil. The fungal spores become airborne when wind blows the dust around, are easily inhaled and settle deep in the lungs, causing pneumonia.
The updated guidelines are now much more geared towards primary care clinicians who typically are the first to see and treat patients with pneumonia, but who may overlook valley fever as a potential cause of the illness and prescribe unnecessary tests and therapy.
While 60 percent of people with valley fever have a mild infection with few or no symptoms, others may have fever, fatigue, cough, headache, chest pain, skin rash and joint aches. In extreme cases it can cause severe pneumonia, holes in the lungs (cavities), lung nodules, skin sores and meningitis. Pregnant women and people who are immunosuppressed (those with HIV, who had an organ transplant or are taking medication for rheumatologic disease) or have diabetes have a very high risk of complications.
Guideline Highlights
1) Fifty to 80 percent of people infected don’t require medication. Their immune systems eventually will rid their bodies of the infection and they will become immune. However, patients may benefit from physical therapy and should be seen by a health care provider regularly for two years to ensure their symptoms aren’t worsening, the guidelines say.
