Coccidioidomycosis - disseminated
Disseminated coccidioidomycosis is caused by breathing in the spores of a fungus found in desert regions. The infection spreads throughout the body and is especially common in immunosuppressed people. Antifungals may help but the death rate is very high.
Also known as: Coccidioidomycosis - systemic
- Diabetes
- A suppressed immune system (immunosuppression), such as that caused by HIV infection or AIDS
- Pregnancy
- Medicines that weaken your immune system, including steroids, TNF-inhibitors, and chemotherapy drugs
- Lymphoma
- Cough
- Fever
- Chills
- Headache
- Muscle stiffness
- Muscle aches
- Neck or shoulder stiffness
- Change in mental status
- Sensitivity to light
- Joint swelling
- Joint pain
- Skin reaction (erythema nodosum)
- Arthritis
- Ankle, feet, and leg swelling
- CBC with differential
- Chest x-ray
- Coccidioidin skin test
- Sputum KOH test
- Coccidioides complement fixation titer to measure antibodies to the Coccidioides fungus in the blood
- Sputum culture
Definition
Disseminated coccidioidomycosis is a fungal infection that spreads through the bloodstream and involves many organs.
Causes, incidence, and risk factors
Coccidioidomycosis is caused by breathing in spores from the fungi Coccidioides immitis or Coccidioides posadasii. These fungi are found in the soil in certain parts of the southwestern U.S., Mexico, and Central and South America.
The following increase your risk of disseminated coccidioidomycosis:
Symptoms
Most acute infections cause no symptoms. Other times, the symptoms range from mild to severe.
Symptoms include:
Other symptoms that may occur with this disease:
Signs and tests
Tests that may be done include:
A biopsy of tissue may be done to determine the area of disseminated disease:
A brain and nervous system (neurological) examination may show abnormalities.
Treatment
Bed rest and improved nutrition are recommended. Antifungal drugs are prescribed to treat the infection.
Expectations (prognosis)
People with disseminated disease have a high death rate. Death may be rapid for patients with a suppressed immune system.
Complications
In the disseminated form of the disease, the infection may spread to the bones, lungs, liver, brain, skin, heart, and sac around the heart (pericardium). Meningitis is the most serious type of disseminated disease.
Calling your health care provider
Call for an appointment with your health care provider if you have symptoms of disseminated coccidioidomycosis.
Prevention
Maintaining good health will limit the disease to a harmless lung illness. Preventing AIDS or other causes of an impaired immune system will generally prevent the more severe forms of the disease.
References
Galgiani J. Coccidioides species. In: Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2005:chap 264.
Galgiani JN. Coccidioidomycosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 354.
- Review date:
- August 28, 2009
- Reviewed by:
- David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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