How frequently does uncomplicated acute pneumonia in coccidioidomycosis resolve spontaneously?

Updated: Aug 27, 2019
  • Author: Duane R Hospenthal, MD, PhD, FACP, FIDSA, FASTMH; Chief Editor: Michael Stuart Bronze, MD  more...
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Antifungal therapy is not usually necessary for uncomplicated acute primary coccidioidal pneumonia. Because coccidioidal pneumonia resolves spontaneously in 95% of cases without any treatment, most uncomplicated cases can be managed with follow-up visits every 3-6 months for as long as 2 years to confirm resolution of symptoms and radiographic abnormalities.

Although no studies demonstrate that therapy hastens resolution or stops dissemination, some experts propose treatment of all symptomatic patients, especially if risk factors are present. Patients with a higher clinical severity score and symptom score are more likely to be treated. Outcomes are not significantly different, although more complications have been seen in those with cessation of treatment. [9, 84]

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