Coccidioidomycosis
Valley fever is a fungal infection most commonly seen in the
desert regions of the southwestern United States, and in Central and South
America. You get it by breathing in fungal particles from soil. The infection
starts in the lungs. Valley fever may also be called coccidioidomycosis. Traveling
to an area where the fungus is commonly seen raises your risk for this
infection. You are also more likely to develop a serious infection if you have
a weakened immune system due to:[i]
The initial, acute form of coccidioidomycosis is often mild,
with few, if any, symptoms. When signs and symptoms do occur, they appear one
to three weeks after exposure. They tend to resemble those of the flu, and can
range from minor to severe: Fever, Cough, Chest pain — varying from a mild feeling of
constriction to intense pressure resembling a heart attack, Chills, Night sweats, Headache, Fatigue, Shortness of breath, Joint aches, Red, spotty rash[ii]
There is no vaccine at this time for Valley Fever. Most people
are able to fight off Valley Fever on their own without treatment. They usually
don't get it again. For those that seek treatment, antifungal drugs (not
antibiotics) are used. Although these treatments are often helpful, the disease
may persist and years of treatment may be required. If a lung cavity ruptures
as mentioned above, surgery may be necessary.[iii]
The majority of cases (over 60%) spontaneously resolves and
requires no treatment. However, there are several antifungal drugs available to
treat coccidioidomycosis if needed. The drug of choice is usually amphotericin
B, but oral azoles (fluconazole [Diflucan], itraconazole [Sporanox],
ketoconazole [Nizoral]) and a triazole (posaconazole) can be used. A new drug
called voriconazole may also be used. Most of these drugs have side effects,
and most have not been proven safe to use in pregnant patients except for
amphotericin B. High relapse rates can occur with some patients (about 75%
relapse with brain involvement), requiring lifelong antifungal therapy. In
general, dosage (especially pediatric), length of time of drug administration,
and the choice of drug is best decided in consultation with an infectious
disease specialist.
Surgical treatment is sometimes needed. Pulmonary cavities,
persistent pulmonary infection, empyema (pus collection), and shunt placement
are some of the surgical interventions used to treat this disease.
Other treatments (for example, prednisone [Deltasone, Liquid
Pred] or alternative therapy such as dietary modification) are not currently
recommended by most physicians; people should consult with their physician
before trying to use such methods[iv].
Coccidioidomycosis was first discovered in the early 1890’s in
Domingo Ezcurra, an Argentinean soldier.
Some pathologists believed his skin conditions were the result of cancer. After tissue biopsies his illness was thought
to resemble the protozoan coccidia, often found in chickens. To this day the
name of coccidioidomycosis still represents this early misdiagnosis. The
Ezcurra case was followed for eleven years and he ultimately died of his
illness.
By 1900 coccidioidomycosis was established as a fungal
disease. After an outbreak in the 1930’s
in the San Joaquin Valley of California, this disease was given its nickname
“San Joaquin Valley Fever,” often shortened further to “Valley Fever.” The disease threatened national security
during World War II when thousands of American soldiers became sickened while
training in the Southwest. It even affects our military today -- as seen during
a 2002 Navy Seal training exercise in California when 45% of the squad fell
ill. There is still no cure for coccidioidomycosis and no vaccine.[v]
1 comment:
Also, as is usually the case, according to my girlfriend who is an RN, Coccidioidomycosis is usually the result of a much larger infection or disease. Those susceptible to it often times suffer from Cancer, HIV and other autoimmune infections, viruses or diseases. Not to say that this is the case for Ike but I hope the team errs on the side of caution and runs a battery of tests to make sure.
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