Scientific Name:
Coccidioides immitis
Valley Fever is a fungus that is inhaled
Found mainly in the southwestern states and South America
Valley Fever can have devastating effects
Current treatments are extremely unpleasant
Treatment can last a year or more

The spores are spread through dust storms or when the earth is disturbed
Infects mainly the lungs but can easily spread throughout
After one infection, develop immunity
Not contagious person to person

30-40% of residents of Phoenix, Arizona and Bakersfield CA have it or have had it
(Center for Excellence)
Approximately 100,000 new cases a year and rising (Center for Excellence)
Animals get it also
Dogs, chickens, and horses

Most dangerous to:
People with autoimmune disease
Males
African-American and Filipino
3 rd trimester pregnancies
Elderly and young children
Recent transplant patients

Coccidioidal spherule found in spleen
The spherule contains innumerable endospores which mature and are released when the spherule ruptures.
The endospores then re-infect and form more spherules.

Coccidioidal spherule found in sputum stained with Papanicolaou's stain (next slide).
Coccidioidal spherules, if present, may be found when sputum or other respiratory specimens are submitted for detection of lung cancer cells.

Mycelial form of a mature colony of
Coccidioides immitis growing on blood agar culture medium (next slide).
The filamentous hair-like extensions break up into microscopic arthroconidia
("spores") which are easily dispersed by the wind when soil is disturbed.

Coccidioidomycosis (arthroconidia from colony)

Coccidioidomycosis (KOH) rupturing mature spherule

Develop nodules in lungs which develop into cavities
Requires surgery if these cavities rupture
Usually will disappear in two years
Cause chest pain and difficulty breathing

Most common site of dissemination is the skin
Can grow a culture of Cocci from skin lesions

Bones and joints can also be infected
Most common sites:
Knees
Vertebra
Wrists

Meningitis is the most serious and lethal site of dissemination
Symptoms include:
Headache
Vomiting
Stiff neck
Central Nervous system disturbances
Spinal tap is required for diagnosis

Bed rest is most often prescribed
4 different anti-fungal drug treatments available and all are quite unpleasant and often toxic
Treatment can continue for a year or more
Doesn’t actually kill the fungus but keeps it from spreading

Amphotericin B: considered by patients to be
“the worst” treatment and most prescribed side effects: nausea, fever and kidney damage
3 new oral drugs ketoconazole fluconazole itraconazole
In the case of damaged bone or organ tissue surgery is required

Incidents of lethal infection rising (JAMA)
More people
More cases of HIV
Drug companies are now developing vaccine
Current estimates are that it will be another 7 years until it’s on the market

Valley Fever Center for Excellence. Coccidioidomycosis http://www.arl.arizona.edu/vfce/ n.pag.
. 11 Oct 2001.
Stokesbary, Robert. Home page. N.pag. 11 Oct 2001 http://www.flash.net/~breaman/vallyfvr.html
Dust and Coccidioidomycosis. Family Practice News, Dec 15, 2000 v30 i24 p15
Galgiani, John N. Coccidioidomycosis.
August 1993 v159 n2 p153(19)
The Western Journal of Medicine .
JAMA, The Journal of the American Medical Association, Jan 8, 1997 v277 n2 p104(2) ( Statistics from the Centers for Disease Control and
Prevention)
Sudilovsky, Daniel and Spiegel, Jefferey H.Coccidioidomycosis. (Quiz Case
2). Archives of Otolaryngology - Head & Neck Surgery, Oct 1999 v125 i10 p1161