Coccidioidomycosis Osteoarticular Dissemination.

Area of Science:

• Mycology
• Infectious Diseases
• Rheumatology

Background:

• Valley fever, caused by *Coccidioides* fungi, is endemic to California and Arizona.
• Skeletal coccidioidomycosis, often affecting the spine, comprises half of disseminated infections.
• Bone and joint involvement leads to destruction, pain, and mobility loss, posing diagnostic challenges.

Purpose of the Study:

• To review literature on coccidioidomycosis dissemination to bones and joints.
• To identify knowledge gaps in understanding susceptibility to extrapulmonary infection.
• To propose research questions for improved diagnosis and treatment.

Main Methods:

• Literature review of published reviews, case reports, and case series.
• Analysis of clinical and animal data regarding skeletal coccidioidomycosis.
• Identification of differential diagnostic features and research opportunities.

Main Results:

• Skeletal coccidioidomycosis presents nonspecific symptoms, complicating diagnosis, especially outside endemic areas.
• Dissemination commonly affects the vertebral spine and adjacent soft tissues.
• Limited understanding of mechanisms underlying bone and joint susceptibility exists.

Conclusions:

• Early and accurate diagnosis of skeletal coccidioidomycosis is crucial but challenging.
• Further mechanistic and basic research is needed to develop novel diagnostic and therapeutic strategies.
• Addressing knowledge gaps can improve patient outcomes for this debilitating infection.