By: Tamara Leach
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
3rd 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. 11 Oct 2001.
http://www.arl.arizona.edu/vfce/ n.pag.
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. The Western Journal of Medicine.
August 1993 v159 n2 p153(19)
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