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valley fever

Alternative Names
San Joaquin Valley Fever, coccidioidomycosis

Definition
Valley fever is an infection, usually in the lungs, caused by the fungus Coccidioides immitis. It is called valley fever because the fungus is commonly found in the soil of the valleys of the southwestern US, Mexico, and parts of Central and South America.

What is going on in the body?
Valley fever may cause a range of mild symptoms, and a mild lung infection. Or the infection may be severe and progressive, and spread throughout the body, which can be fatal.

What are the signs and symptoms of the infection?
Many times valley fever causes no symptoms at all. If symptoms do develop, they usually appear 1 to 3 weeks after infection, and may include: What are the causes and risks of the infection?
Valley fever is caused by a fungus that thrives in the soil. An infection occurs when a person breathes in dust from soil that contains the fungus. The disease is commonly found in California's San Joaquin Valley, southern and central Arizona, and southwest Texas. A person who works outdoors in those areas may be at a higher risk.

What can be done to prevent the infection?
Currently there is no way to prevent the infection. A person who lives in the areas where the infection is common should avoid exposure to dust and dry soil as much as possible.

How is the infection diagnosed?
A doctor may suspect this infection if the person lives in or has recently traveled through an infected area. A history and physical examination may reveal some of the symptoms common to valley fever. A chest x-ray, blood tests, including a full blood count or FBC, and a spinal tap may also be done. A blood culture will reveal the presence of the infection.

What are the long-term effects of the infection?
Valley fever can form lung abscesses, or pus pockets, which can be difficult to treat. Occasionally the infection spreads throughout the body, causing lesions in the bones and other organs. In those cases, the mortality rate can reach 60%. In rare cases, the disease may recur within a few months. Valley fever tends to be more serious in dark-skinned people, pregnant women, or people with weakened immune systems.

What are the risks to others?
Valley fever may be spread to others through contaminated dressings of infected people.

What are the treatments for the infection?
The acute form of valley fever normally clears up without treatment. Bed rest and fever- reducing medications may be recommended. In more severe cases, fungus-killing medications may be used.

A doctor may prescribe amphotericin B to be given through a vein. In cases of recurrence, a medication such as ketoconazole may be prescribed between courses of amphotericin. In severe cases, surgery may be needed to drain abscesses in the lungs.

What are the side effects of the treatments?
Possible side effects of the medications include stomach upset, allergic reactions, and irritation at the site in the vein where the medication is being given. Any surgery poses a risk of infection, bleeding, and allergic reaction to the anaesthesia.

What happens after treatment for the infection?
After treatment, valley fever usually goes away. In rare cases, the infection recurs, and further treatment is needed.

How is the infection monitored?
In cases of continued infection, the person may be monitored for recurrent symptoms. Any new or worsening symptoms should be reported to the doctor.

Author: John Riddle
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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