Coccidioidomycosis - chronic pulmonary
Key points
- Chronic pulmonary coccidioidomycosis is a disease caused by breathing in a fungus found in the soil in certain parts of the southwestern U.S., Mexico, and Central and South America that can cause a chronic lung (pulmonary) condition.
- The infection is caused by breathing in the spores of a fungus found in desert regions such as Arizona or California's San Joaquin Valley.
- Treatment Antifungal medications are prescribed to treat the infection.
- With treatment the outcome is usually good although relapses may occur.
Definition
Chronic pulmonary coccidioidomycosis is a disease caused by breathing in a fungus found in the soil in certain parts of the southwestern U.S., Mexico, and Central and South America that can cause a chronic lung (pulmonary) condition.
Causes, incidence, and risk factors
The infection is caused by breathing in the spores of a fungus found in desert regions such as Arizona or California's San Joaquin Valley. The disease can have an acute, chronic, or disseminated form.
The chronic form usually develops after a latent period of months to years following an initial benign infection which may go undiagnosed. Lung abscesses may form and may rupture into the pleural spaces causing empyema (pus in the pleural space) or bronchopleural fistula. Scarring (fibrosis) and cavities may gradually form in the upper lungs as the chronic form of coccidioidomycosis slowly progresses over months to years.
Still, the majority of pulmonary coccidioidomycosis infections do not become chronic. In fact, the majority of infections cause no symptoms and are only recognized by a positive coccidioidin skin test.
Dark skinned people and people with a weak immune system are more susceptible to infection and more likely to form chronic or disseminated (spreading to other organs) forms of the disease.
Symptoms
- chronic cough
- blood tinged sputum
- loss of appetite
- weight loss
- fever
- shortness of breath
Additional symptoms that may be associated with this disease:
- wheezing
- sweating, excessive
- joint stiffness
- chest pain
- headache
Signs and tests
- sputum smear (KOH test)
- sputum fungal culture
- serum coccidioides complement fixationtiter (serology)
- CBC with differential
- chest X-ray
- chest CT scan
- coccidioidin or spherulin skin test
- bronchoscopy
- bronchoscopy with transbronchial biopsy
- open lung biopsy
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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