What is the prognosis 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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Most patients with coccidioidomycosis have an excellent prognosis; most infections are self-limited and resolve within a few months without the need for medical intervention. In more than 90% of symptomatic individuals, no further sequelae develop. Treatment with antifungal therapy is effective in most of the defined clinical syndromes, however, and therefore the prognosis for recovery in these patients is also excellent.

Chronic coccidioidomycosis develops in 5-8% of patients following primary pulmonary disease. This is characterized by pulmonary disease, with or without extrapulmonary spread, or by extrapulmonary disease alone. Chronic pulmonary disease generally represents failure of local defenses and is commonly associated with advanced age and/or diabetes. The most common forms are cavity or nodule formation, which frequently represent a transition from acute disease to resolution.

Fewer than 1% of patients progress to disseminated disease. Patients with suppressed immune systems or those taking immunosuppressant medications are especially at risk for progressive or disseminated disease, and their coccidioidal infections may be difficult to eradicate.

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