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Related Experiment Videos

Coccidioidomycosis.

E R Hobbs1

  • 1Department of Dermatology, Wilford Hall USAF Medical Center, Lackland AFB, Texas.

Dermatologic Clinics
|April 1, 1989
PubMed
Summary
This summary is machine-generated.

Coccidioides immitis infections, or valley fever, are increasing due to population growth, but environmental factors may be reducing prevalence. Advances in diagnosis and treatment offer a good prognosis for immunocompetent patients.

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Area of Science:

  • Mycology and Infectious Diseases
  • Dermatology
  • Epidemiology

Background:

  • Increasing population and travel in the Southwestern US raise exposure risk to Coccidioides immitis.
  • Environmental factors may be contributing to declining prevalence in some endemic regions.
  • Iatrogenic and inherent immunosuppression (e.g., organ transplantation, AIDS) increase risk of opportunistic Coccidioides infections.

Purpose of the Study:

  • To review the current understanding of Coccidioides immitis infections, including epidemiology, clinical manifestations, diagnosis, and treatment.
  • To highlight challenges in diagnosing diverse cutaneous presentations.
  • To discuss advancements in diagnostic tools and therapeutic options.

Main Methods:

  • Review of epidemiological trends and environmental factors influencing Coccidioides immitis prevalence.

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  • Analysis of clinical presentations, particularly cutaneous manifestations.
  • Evaluation of diagnostic advancements, including spherule-derived coccidioidin and serodiagnostic techniques.
  • Assessment of therapeutic strategies, including established and investigational antifungal agents.

    • Main Results:

    • Despite increased exposure potential, prevalence has declined in some areas, possibly due to environmental factors.
    • Cutaneous manifestations of Coccidioides immitis infection remain diagnostically challenging for dermatologists.
    • Improved diagnostic tools (spherule-derived coccidioidin, serodiagnostics) aid in management.
    • Amphotericin B is standard, ketoconazole is effective, and itraconazole shows promise.
    • Morbidity and mortality from disseminated disease are decreasing.

    Conclusions:

    • Current diagnostic and therapeutic advancements have improved the management of Coccidioides immitis infections.
    • The prognosis for survival in immunocompetent individuals with Coccidioides immitis infection is excellent.
    • Continued vigilance and research are necessary, especially with rising immunosuppression rates.