Chapter 2: coccidioidomycosis

Area of Science:

• Mycology
• Infectious Diseases
• Pulmonology

Background:

• Coccidioidomycosis is a systemic fungal infection caused by Coccidioides immitis and Coccidioides posadasii.
• Infection occurs via inhalation of arthroconidia found in soil, endemic to arid/semi-arid regions globally.
• While often benign, it can progress to pulmonary or disseminated forms.

Purpose of the Study:

• To provide a comprehensive overview of coccidioidomycosis, including its causes, epidemiology, clinical manifestations, diagnosis, and treatment.
• To highlight recent reports of coccidioidomycosis in northeastern Brazil, expanding its known endemic range.
• To inform clinicians and researchers about the current understanding and management of this fungal infection.

Main Methods:

• Review of existing literature on Coccidioidomycosis.
• Analysis of epidemiological data, including recent cases in Brazil.
• Description of diagnostic techniques and imaging findings.
• Summary of current treatment guidelines for various clinical forms.

Main Results:

• Coccidioidomycosis presents in pulmonary and disseminated forms, with symptoms typically appearing 10 days post-exposure.
• Diagnostic methods include fungal culture, microscopy (KOH, PAS, silver stains), and serological tests like agar gel immunodiffusion.
• Radiological findings often show diffuse pulmonary nodules, frequently cavitated.
• Antifungal treatment with fluconazole or itraconazole is standard; amphotericin B is used for severe cases or neurological involvement.

Conclusions:

• Coccidioidomycosis requires prompt diagnosis and appropriate antifungal therapy.
• The expanding geographical distribution, including recent cases in Brazil, necessitates increased awareness.
• Effective management relies on understanding the diverse clinical presentations and employing targeted treatment strategies.