Valley fever (coccidiomycosis or coccidioidomycosis) is a common fungal infection found in people living and/or working in the San Joaquin Valley area of California as well as portions of Arizona, Utah, New Mexico, Texas, Nevada, and Mexico. The disease is caused by inhaling fungal spores that are transported by the wind often associated with construction, farming, or ranching activities which have stirred up the soil. Valley fever is not passed from one person to another. Symptoms of the infection can range from unnoticeable to very severe and usually appear 1-3 weeks after exposure when an individual has inhaled the spores into his or her lungs. Common symptoms of valley fever include fever, chills, night sweats, cough, chest pain, headache, fatigue, achy muscles and/or joints or a bumpy red rash often found on the shins. Often the patient may feel like they just have the “flu.” The severity of the symptoms is often dependent on the dose of spores inhaled and the patient’s overall health status. Frequently, mild cocci or a suspicious spot shows up on a later chest x-ray. Chronic cases of cocci pneumonia may present as chronic chest discomfort, cough (with or without bloody phlegm), fever, or unexplained weight loss. Widespread or disseminated cocci infections can be life-threatening and affect the skin, bones, heart, liver, brain, or brain membranes (meninges).
There are multiple risk factors for severe pneumonia or disseminated infection. These factors include environmental exposure issues such as construction workers, farmers, ranchers, archaeologists, and military personnel on field maneuvers. Filipinos, Asians, African-Americans, Native Americans, and Hispanics are also a greater risk for unknown reasons. Aging increases risk as does pregnancy. Anyone with a compromised immune system is at increased risk such as individuals with HIV/AIDS, cancer, chemotherapy treatments, anti-rejection drug therapy for organ transplant recipients, and people on long term steroid therapy.
Treatment of mild cases is simply fluids and rest. Most cases resolve spontaneously without medication. More severe or persistent cases may need anti-fungal medication such as fluconazole. Most people are immune after a single infection but individuals with weak immune systems may develop re-infection. There is currently no vaccine available for valley fever. Anyone concerned that, they may have valley fever should contact their local health care provider for evaluation.
Article written by Gary Towle, MD.