Recognizing coccidioidomycosis

Primary pulmonary coccidioidomycosis is usually a self-limited disease. It is characterized by fever, nonproductive cough and chest pain. Manifestations of hypersensitivity, such as skin lesions and polyserositis, are often present. Persistence of symptoms beyond eight weeks, continuously positive sputum cultures or negative skin tests with high serum complement-fixation titers for coccidiodomycosis suggest local progression or hematogenous spread. These situations are indications for antifungal therapy.