Coccidioidomycosis Chronic Pulmonary Disease

What is Coccidioidomycosis?

Also termed as Valley Fever, Coccidioidomycosis is an infectious disease generated by breathing in spores from the fungus which are present in the soil of some arid portions of the southwestern US Mexico and Central America. It generally thrives in the desert. Your cat can carry this infection just by sniffing the ground and inhaling the spores.

Causes

About 60% of infections shows no symptoms and are only identified later by coccidioidin skin test which turns positive

  • Inhaling the fungus spores is the source of infection.
  • In 40% of the cases, symptoms may range from mild to severe.
  • Person with a compromised immunity are tend to have more dangerous infections.
  • Individuals with AIDS are at greater risk for lung (pulmonary) coccidioidomycosis in addition to the disseminated and skin forms of the disease.
  • The ailment may display a serious, chronic, or disseminated form.
  • Acute pulmonary coccidioidomycosis is most of the time mild, having some or no symptoms at all, and it may be left untreated.
  • Acute coccidioidomycosis is quite rare.

In this disease, infection may reach the bones, liver, lungs, lining covering of the brain, heart, skin, spinal cord and the sac around the heart. The disease may deteriorate fast in immunosuppressed individual.

Symptoms of Coccidioidomycosis

Symptoms may surface between 1 to 3 weeks after infection. More than 50% of infections do not display any symptoms.

  • It can grow within 20 or more years after being identified, which may not have been treated at the time.
  • Infections can create and snap, releasing pus in the lungs and ribs. This ailment is generally rare than found in its acute form.
  • People who show symptoms can experience flu-like symptoms, fever, headache, cough, rashes and muscle pains.
  • When the infection extends outside the lungs, it generally leads to skin lesions, central nervous system, for instance meningitis, and joint and bone infection.

Most people recovers fully, within weeks to months of the display of symptoms, but a limited number of persons may get chronic pulmonary infection. Some people are at higher risk for contacting the disseminated infection. These people are African-American, Filipino and Asian along with expected women during their third trimester and immunocompromised persons.

Treatment for Coccidioidomycosis

This ailment may fade away on their own, without any treatment.

However, some physicians generally recommend antifungal medications, like fluconazole, to treat patients suffering from acute, less intensive coccidioidomycosis. Sufficient detail is not available whether treating acute, uncomplicated pulmonary coccidioidomycosis is recommended or not, nevertheless many experts feel that people are at the risk for catching severe diseases must receive treatment.

In more serious infections, treatment with antifungal medication is imperative. People suffering with pneumonia from coccidioidomycosis in both lungs, people having disseminated ailment, and individuals having chronic pneumonia, all require treatment.

Prevention of Coccidioidomycosis

Avoiding dusty environments in endemic areas can help to prevent infection. In addition, people prone to severe ailment must ward off activities that may lead to dust exposure, i.e. digging.

Risk Factors

The records say that both acute pulmonary coccidioidomycosis and the chronic disease are found in the ratio of 1 in 100,000 people.

  • Coccidioidomycosis is localized in the western hemisphere that stretches from California to Argentina.
  • Coccidioidomycosis is also identified outside these regions as travelers move around.
  • The local residents of endemic areas suffer natural calamities, for instance dust storms creating new epidemics and earthquakes.
  • Risk of infection is higher on windy atmosphere when the soil is dry or when the soil is mostly active.
  • About 3% of people living in areas where coccidiomycosis is generally reported are prone to this disease.
  • Areas outside the US with a greater risk are exposed to semi-arid climates having hot summers and alkaline soil embodies, like Central and South America and northern Mexico.
  • Filipinos are at greater risk of getting infected, almost about 10-170 times more prone to that of whites.
  • Blacks and Hispanics are also at higher risk of getting infected compared with whites.
  • In disseminated ailment, the surviving rates in newborns are much greater than those in children and adults.

Medication

  • Amphotericin B is the drug, mostly used to treat disseminated coccidioidomycosis.
  • Of late, oral azoles have offered a potential substitute for both initial therapy and completion of dose courses after amphotericin therapy.
  • The benefits of azoles are oral formulations and lesser adverse effects.
  • Large, multicenter, non-randomized medical researchers have reported the reaction of chronic pulmonary and disseminated coccidioidal infections to oral azoles and have detected appropriate treatment proficiency but high reoccurrence rates upon cessation of therapy.
  • Other azoles can also be effective in the treatment of Coccidioidin species.
  • Research on the use of immunomodulators to enhance T-cell response to coccidioidal infection is yet to be identified and is in the pipeline.
  • A new triazole antifungal, posaconazole (Noxafil), has been approved by the US Food and Drug Administration (FDA).