Coccidioidomycosis

 

://www.cdc.gov/ncidod">National Center for Infectious Diseases Division of Bacterial and Mycotic Diseases   Clinical Features Symptomatic infection (40% of cases) usually presents as influenza-like illness with fever, cough, headaches, rash, and myalgias; also can present as acute pneumonia, rarely as chronic pneumonia, or as disseminated form (affecting meninges, skin, and bone). Severe pulmonary disease may develop in HIV-infected persons. Etiologic Agent Coccidioides immitis. Reservoir Soil in semiarid areas (primarily in the Lower Sonoran life zone). Endemic in the south-western United States, parts of Mexico and South America. Incidence Incidence was 15 cases per 100,000 population in Arizona in 1995. Of persons living in areas with endemic disease, 10-50% are skin-test positive. Sequelae Meningitis may lead to permanent neurologic damage. Mortality is high in HIV-infected persons with diffuse lung disease. Transmission Inhalation of airborne arthroconidia after disturbance of contaminated soil by humans or natural disasters (e.g., dust storms and earthquakes). Risk Groups Persons in areas with endemic disease who have occupations exposing them to dust (e.g., construction or agricultural workers, and archeologists). High risk groups are African-Americans and Asians, pregnant women during the third trimester, and immunocompromised persons. Surveillance National surveillance through NETSS started in 1995. Reportable in states with endemic disease: California, New Mexico, Arizona. Challenges