Coccidioidomycosis, commonly known as San Joaquin Valley fever Fever Fever is defined as a measured body temperature of at least 38°C (100.4°F). Fever is caused by circulating endogenous and/or exogenous pyrogens that increase levels of prostaglandin E2 in the hypothalamus. Fever is commonly associated with chills, rigors, sweating, and flushing of the skin. Fever, is a fungal disease caused by Coccidioides immitis or Coccidioides posadasii. When Coccidioides spores Spores The reproductive elements of lower organisms, such as bacteria; fungi; and cryptogamic plants. Anthrax are inhaled, they transform into spherules that result in infection. Coccidioidomycosis is also a common cause of community-acquired pneumonia Community-Acquired Pneumonia Pneumonia in Children and can cause severe disease in the immunocompromised immunocompromised A human or animal whose immunologic mechanism is deficient because of an immunodeficiency disorder or other disease or as the result of the administration of immunosuppressive drugs or radiation. Gastroenteritis. Patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship may present with fever Fever Fever is defined as a measured body temperature of at least 38°C (100.4°F). Fever is caused by circulating endogenous and/or exogenous pyrogens that increase levels of prostaglandin E2 in the hypothalamus. Fever is commonly associated with chills, rigors, sweating, and flushing of the skin. Fever, chills Chills The sudden sensation of being cold. It may be accompanied by shivering. Fever, cough, chest pain Chest Pain Chest pain is one of the most common and challenging complaints that may present in an inpatient and outpatient setting. The differential diagnosis of chest pain is large and includes cardiac, gastrointestinal, pulmonary, musculoskeletal, and psychiatric etiologies. Chest Pain, and shortness of breath Shortness of breath Dyspnea is the subjective sensation of breathing discomfort. Dyspnea is a normal manifestation of heavy physical or psychological exertion, but also may be caused by underlying conditions (both pulmonary and extrapulmonary). Dyspnea. The diagnosis is supported by clinical history, radiology, microscopy, fungal culture, and serological data. Management involves antifungals and supportive care. In severe disease, addressing the etiology of immunosuppression is critical.
Last updated: 17 Jun, 2021
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This image depicts a photomicrograph of a lung tissue specimen, revealing some of the ultrastructural histopathology exhibited in a case of pulmonary coccidioidomycosis.
Note the mature spherule with its contents of Coccidioides immitis endospores, as well as an intense infiltrate of
neutrophils
Neutrophils
Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes.
Innate Immunity: Phagocytes and Antigen Presentation.
Photomicrograph showing the presence of thin, septate, hyaline hyphae Hyphae Microscopic threadlike filaments in fungi that are filled with a layer of protoplasm. Collectively, the hyphae make up the mycelium. Mycology, from which numerous thick-walled Coccidioides immitis arthroconidia had evolved
Image: “Photomicrograph showing the presence of thin, septate, hyaline hyphae Hyphae Microscopic threadlike filaments in fungi that are filled with a layer of protoplasm. Collectively, the hyphae make up the mycelium. Mycology, from which numerous, thick walled, Coccidioides immitis arthroconidia had evolved” by CDC/ Lucille Georg. License: Public DomainCoccidioidomycosis (also known as San Joaquin Valley fever Fever Fever is defined as a measured body temperature of at least 38°C (100.4°F). Fever is caused by circulating endogenous and/or exogenous pyrogens that increase levels of prostaglandin E2 in the hypothalamus. Fever is commonly associated with chills, rigors, sweating, and flushing of the skin. Fever) can be caused by:
Coccidioides arthroconidia can become airborne when soil is disturbed, allowing transmission via inhalation.
The clinical presentation Presentation The position or orientation of the fetus at near term or during obstetric labor, determined by its relation to the spine of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the neck. Normal and Abnormal Labor can vary from asymptomatic to life-threatening. The incubation Incubation The amount time between exposure to an infectious agent and becoming symptomatic. Rabies Virus period is 1–4 weeks after exposure Exposure ABCDE Assessment.
Cutaneous involvement may occur in conjunction with pulmonary involvement, with direct inoculation, or from disseminated disease.
Skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions lesions caused by Coccidioides infection
Image: “A skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions lesion due to Coccidioides infection” by CDC/Dr. Lucille K. Georg. License: Public DomainA posterior view of a patient’s torso with marked cutaneous scarring Scarring Inflammation over both buttocks after treatment for coccidioidomycosis
Image: “This image depicts a posterior view of a patient’s torso, who had undergone treatment with amphotericin B Amphotericin B Macrolide antifungal antibiotic produced by streptomyces nodosus obtained from soil of the orinoco river region of venezuela. Polyenes, in this case of coccidioidomycosis, also known as valley fever Fever Fever is defined as a measured body temperature of at least 38°C (100.4°F). Fever is caused by circulating endogenous and/or exogenous pyrogens that increase levels of prostaglandin E2 in the hypothalamus. Fever is commonly associated with chills, rigors, sweating, and flushing of the skin. Fever, caused by the fungal organism, Coccidioides immitis” by CDC/Dr. Brodsky. License: Public DomainDisseminated infection is defined as disease outside the thoracic cavity and is considered an AIDS-defining illness. Patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship can present with the following (this list is not exhaustive):
“Desert rheumatism” is often defined by the presence of:
The diagnosis is made based on history and physical exam with supporting imaging and laboratory data.
This anteroposterior chest
X-ray
X-ray
Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source.
Pulmonary Function Tests revealed pulmonary changes indicative of
pulmonary fibrosis
Pulmonary Fibrosis
Idiopathic pulmonary fibrosis is a specific entity of the major idiopathic interstitial pneumonia classification of interstitial lung diseases. As implied by the name, the exact causes are poorly understood. Patients often present in the moderate to advanced stage with progressive dyspnea and nonproductive cough.
Pulmonary Fibrosis in a case of coccidioidomycosis, caused by fungal organisms of the genus Coccidioides:
Because these changes also resemble those seen in other lung
infections
Infections
Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases.
Chronic Granulomatous Disease, including
tuberculosis
Tuberculosis
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis complex bacteria. The bacteria usually attack the lungs but can also damage other parts of the body. Approximately 30% of people around the world are infected with this pathogen, with the majority harboring a latent infection. Tuberculosis spreads through the air when a person with active pulmonary infection coughs or sneezes.
Tuberculosis, the findings uncovered with a chest
X-ray
X-ray
Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source.
Pulmonary Function Tests need to be coupled with serologic testing as well as possible tissue
biopsy
Biopsy
Removal and pathologic examination of specimens from the living body.
Ewing Sarcoma. The degree of fibrotic changes, indicative of
scarring
Scarring
Inflammation found on
X-ray
X-ray
Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source.
Pulmonary Function Tests, can be directly correlated to the severity of the fungal infection.
Listed complications are associated with being immunocompromised immunocompromised A human or animal whose immunologic mechanism is deficient because of an immunodeficiency disorder or other disease or as the result of the administration of immunosuppressive drugs or radiation. Gastroenteritis and/or delay in treatment:
It is difficult to prevent coccidioidomycosis when living in an endemic area. General strategies include: