Coccidioidomycosis, also called Valley Fever, is a silent epidemic in the western hemisphere between 40° north and 40° south. Hot summers and mild winters with an annual rainfall of 10 to 50 cm is typical.

The Fungus grows in the soil that is moist, but the soil must dry out and Be disturbed, such as  by digging, and the wind speed must pick up before you can get the arthrospores into the air so that they can be taken into the lungs.

Most infected people have minimal symptoms. Among those infected, some get a fever and a cough and recover promptly. 3 to 5% of individuals develop a chronic infection. Infected patients with a weak immune system can have disseminated coccidiomycosis affecting virtually any tissue in the body.

Notable coccidiomycosis symptoms include a profound feeling of tiredness, fever, cough, headaches, rash, muscle and joint pain. A loss of the sense of smell is also described, raising some confusion with COVID-19.

Coccidiomycosis can cause a characteristic painful bump in front of the lower leg called erythema nodosum. People with a combination fever, joint pain, and erythema nodosum are said to have “desert rheumatism”.
20% of community acquired pneumonia can be due to coccidiomycosis in endemic areas such as Phoenix Arizona and the San Joaquin Valley.

Immunizations have been evaluated for cost-effectiveness, and the results were not encouraging. More recently, A modification of the coccidiomycosis genome which prevents growth and multiplication of the spore has been tried as a vaccine in mice and found effective.

It is planned to try this noninfectious spore on dogs, who are also very susceptible to the disease. Dogs are a good choice because Government  restrictions and requirements are not so severe, and because people would do almost anything to protect their animals, promising a good market for the vaccine.

A year ago last spring, my brother had a protracted problem which involves his lungs and even his heart, and was admitted to a hospital in Phoenix. Apparently COVID-19 was ruled out, and Coccidiomycosis was diagnosed. The Doctors declined to give him amphotericin or an Azole, the  usual treatments. He recovered, was discharged, and currently is doing well with no residual symptoms.

I was planning to visit him last spring, but I’m glad I stayed home; our immune system‘s are too similar.

–Dr. C

Mayo Clinic article

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