Valley Fever (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Valley fever (coccidioidomycosis) facts
- What is valley fever (coccidioidomycosis)?
- What causes valley fever (coccidioidomycosis)?
- What are the symptoms and signs of valley fever (coccidioidomycosis)?
- How is valley fever (coccidioidomycosis) diagnosed?
- What is the treatment for valley fever (coccidioidomycosis)?
- What is the prognosis (outcome) for valley fever (coccidioidomycosis)?
- What are the risk factors for developing valley fever (coccidioidomycosis)?
- Can valley fever (coccidioidomycosis) be prevented?
- Is valley fever (coccidioidomycosis) contagious?
- Where can one find more information on valley fever?
How is valley fever (coccidioidomycosis) diagnosed?
Early in the disease, the diagnosis is difficult because the symptoms may be mild so no tests are initiated. Accurate diagnosis of coccidioidomycosis is important because there are many diseases that have similar initial symptoms and may occur in areas of the world where coccidioidomycosis occurs; for example, Andes virus (caused by a hantavirus), arbovirus encephalitis (caused by six different viruses), Argentine hemorrhagic fever (an arenavirus infection caused by Junin virus), cryptococcosis (caused by Cryptococcus neoformans, a fungal species), and others. Fortunately, a confirmative diagnostic test is easily done by microscopic examination of sputum or a tissue biopsy. The biopsy shows characteristic fungal spherules and endospores of Coccidioides immitis or Coccidioides posadasii. These fungi can also be identified after they are cultured on fungal media (growth takes about five days). Additionally, there are several serum tests and a PCR test (to detect the genetic material of the fungus) that are available. High blood levels of IgG (an immunoglobulin) that react with the fungi can help determine the extent of the disease. Skin tests can determine if the person has been exposed to the fungi, but the test is not very specific or sensitive.
Other tests help determine the extent of the disease. The most frequent test is a chest X-ray to identify abnormalities in the lungs. MRI and CT scans are used to examine brain or other organ (especially bone) involvement. Bone scans also help to determine the presence of bone involvement. Most physicians will do other routine blood tests such as a CBC (complete blood count) and ESR (erythrocyte sedimentation rate, a marker of inflammation) test.
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