Also known as San Joaquin Valley fever, coccidioidomycosisis mostly found in the southwestern United States and parts of Mexico and Central and South America. The link below contains a PDF with information about the estimated areas with specific fungal agents in the United States.
Life cycle and Infection process:
Coccidioides species stand out with their ability to transition between two distinct phases – the mycelial and spherule phases. This fungal journey unfolds with mycelia(thread-like roots) in the soil, forming a network of hyphae. They transform into arthroconidia(spores) as the environment dries.
Infection occurs when individuals inhale these arthroconidia or experience rare inoculation events. The respiratory system becomes the primary battleground as the fungus establishes its presence within the host. Inside the host, the fungus transforms into spherules, producing internal endospores. These endospores, comparable to fungal seeds, are released into the body, disseminating to nearby or distant tissues.
Most patients experience primary disease, where the lungs take center stage. For some rarer cases, the fungus develops secondary disease, evolving into a chronic process that may involve not only the lungs but also the skin, bones, nervous system, pericardium, peritoneum, skeletal muscles, and the meninges.
Symptoms:
Symptoms include:
Blood in the sputum
Chills
Cough
Fever
Sore throat
Skin involvement like redness, dermatitis and nodule formation
In immunocompromised people, the infection can be more severe, leading to a pneumonia-like lung illness.
This fungus is not contagious.
Diagnosis:
X-ray will show cavities in the lung, similar to the image below.
We can also take sputum samples or lung fluid and examine it under a microscope. It will appear as inflammation with thick walled spherules.
Skin biopsies will show pseudoepitheliomatous hyperplasia of the epidermis(increased cells in the topmost layer of skin) and neutrophils. Spherules will also be seen in skin.
Treatment:
Healthy individuals with minimal disease are able to fight it off without any medications. However, for people at risk of disease dissemination, doctors might prescribe antifungals such as fluconazole. People who have developed disease that has spread outside the lungs usually require hospital admission and prolonged antifungal treatment.
Sources:
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