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- This is a fungal infection caused
by Coccidioides immitis, which comes from a mold that grows
in the soil of the southwestern US (especially deserts of
Arizona), Mexico, and Central and South America. The
infection occurs when dust containing this mold is inhaled.
It is not spread person-to-person. Most individuals have an
uncomplicated syndrome that lasts about 3 months. The more
severe disease syndromes occur usually (but not always) in
those with risk factors, or in certain ethnic groups.
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- Common Infection (in most
cases):
- Flulike illness of dry cough,
fatigue, headache, and backache
- Joint aches and swelling may
occur.
- Rash
- Lymph node enlargement
- Lung abscesses
- Diffuse lung disease
- Meningitis
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- Skin test-becomes positive in 3
weeks to 2-3 months and may last indefinitely.
- Blood titer test (IgM antibody
rises within 2 weeks and disappears in 2 months; IgG rises
within 1-3 months)
- Spinal tap if Meningitis suspected
- Cultures of sputum, joint fluids,
or wounds may grow the fungus.
- Imaging
- Chest X-Ray will show
cavities, infiltrate, enlarged hilar, or mediastinal
nodes.
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- Filipinos
- African Americans
- HIV infected individuals
- Immuno-suppressed individuals
(e.g., taking cancer
chemotherapy)
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- Uncomplicated syndrome -- no
treatment
- Disseminated syndrome --
Amphotericin B intravenously
- Meningitis --
Amphotericin B intravenously followed by oral Fluconazole
indefinitely in severe cases
- Severe cases limited to chest only
-- oral Fluconazole or similar oral medications
- Surgical treatment if abscess forms
and/or ruptures
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