What are the signs and symptoms of coccidioidomycosis?

Updated: Aug 27, 2019
  • Author: Duane R Hospenthal, MD, PhD, FACP, FIDSA, FASTMH; Chief Editor: Michael Stuart Bronze, MD  more...
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In most patients with coccidioidal infection, the primary infection is in the lungs. In 60-65% of cases, this infection is asymptomatic.

In other cases, a mild influenzalike illness develops 1-4 weeks after exposure. The symptoms are indistinguishable from other respiratory illnesses, with fever, sore throat, cough, headache, fatigue, and pleuritic chest pain. Resolution typically occurs over several weeks (although fatigue may persist for months), and 95% or more of patients recover without any further sequelae.

A more involved presentation, with the constellation of fever, arthralgias, erythema nodosum or erythema multiforme, and chest pain is commonly referred to as San Joaquin Valley fever (or simply Valley fever) or desert rheumatism (see Workup).

Coccidioidomycosis spreads beyond the lungs in approximately 0.6% of the infections in the general population. Most extrapulmonary disseminated infections are a result of hematogenous spread. Dissemination can be rapid and fatal. Virtually any organ of the body can be involved (eg, endocrine glands, eye, liver, kidney, prostate, peritoneal cavity), but Coccidioides species has a predilection for the lungs, skin, soft tissue, joints, and CNS, especially the meninges. Meningitis is a grave complication.

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