What is the clinical progression 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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The incubation period of coccidioidomycosis averages 10-16 days, with a range of less than 7 days to 30 days. [2] The natural history of Coccidioides infection is usually one of a self-limited respiratory tract infection. In most cases, symptoms do not occur or are so mild that the infected individual does not seek medical attention. [10, 38] Approximately 30-40% of patients develop symptomatic disease, ranging from a mild influenzalike illness, to subacute pneumonia, to, rarely, respiratory failure.

Common symptoms of primary infection are nonspecific and include fever, cough, chest pain, fatigue, dyspnea, headache, arthralgias, and/or myalgias. Skin manifestations are also seen in a small percentage of cases. In addition to the above symptoms, infection can progress to various presentations. 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.

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