Coccidioidomycosis - Symptoms & Treatment
Coccidioidomycosis is the infection caused by the dimorphic fungus Coccidioides immitis. A fungus found in the soil in certain parts of the southwestern U.S.Coccidioidomycosis is caused by breathing in the spores of a fungus in desert regions. About 60% of acute infections cause no symptoms and are only recognized by a positive coccidioidin skin test . In the remaining 40%, symptoms range from mild to severe. The mold forms arthroconidia within the hypha, a type of conidia formation known as enteroarthric development. C. immitis is the only species within the primary pathogenic fungi that has this type of conidia development. Alternate conidia undergo autolysis, leaving empty spaces between viable arthroconidia. The arthroconidia are released into the atmosphere when the wind ruptures the hypha.C. immitis infects humans and animals almost exclusively by the respiratory route.
The organism is also found in scattered foci in coastal southern California, southern Nevada, and Utah and is endemic in a few areas in Central and South America, especially in Venezuela.These spores are inhaled by the host and reach the pulmonary alveoli; however, they also can be introduced into skin or soft tissue by inoculation into wounds or by trauma. Pulmonary infection can result from inhalation of a single spore in humans. Increased exposure occurs with disruption of soil, which can occur with earthquakes, wind or dust storms, farming, construction, archeological excavations, or with drought following heavy rains. High inoculum exposures are more likely to result in symptomatic disease. Primary infection most often occurs in the dry months of the summer or fall. Person-to-person transmission does not occur. Rare cases of infection from contaminated fomites
Causes of Coccidioidomycosis
Common causes of Coccidioidomycosis
- Soil fungus.
- Dimorphic fungus.
- Spores (Protozoa and bacteria)
Symptoms of Coccidioidomycosis
Common Symptoms of Coccidioidomycosis
- Muscle stiffness.
- Muscle aches.
- Neck stiffness.
- Shoulder stiffness.
- Change in mental status.
- Sensitivity to light.
Treatment of Coccidioidomycosis
Common Treatment of Coccidioidomycosis
- Antifungal therapy of acute primary pulmonary coccidioidomycosis in these high-risk groups consists mainly of oral azoles at the recommended doses (usually 200-400 mg per day) for 3-6 months duration (see Medication ).
- During pregnancy, amphotericin B is the treatment of choice because the azoles may be teratogenic.
- Amphotericin B therapy but have drug-related toxicities, lipid amphotericin B formulations can be considered and have been effective in animal models.
- Hydrocephalus from CNS involvement often requires shunt placement for management.
- Antibiotics (Amphotericin B or ketoconazole)may be given to prevent secondary bacterial infection.