Valley Fever (Coccidioidomycosis)

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Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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• Valley fever (coccidioidomycosis) is a disease caused by a fungus, Coccidioides, which lives in the soil of relatively arid regions (southwest U.S.).
• People are infected by inhaling dust contaminated with Coccidioides; the fungus in not transmitted person to person.
• Although most people infected with Coccidioides have no symptoms, if symptoms develop, they usually occur in the lung and initially resemble the flu or pneumonia (cough, fever, malaise, sputum production, and shortness of breath).
• Some people are more susceptible to infection (immunosuppressed people, those with HIV or cancer, and pregnant females) and may develop widespread disease.
• Diagnosis is usually easy to accomplish, and the disease can be treated by several antifungal medications; there is no vaccine available for valley fever (coccidioidomycosis).

Valley fever (coccidioidomycosis) is a disease caused by fungi (Coccidioides immitis and C. posadasii species) that in about 50%-75% of normal (not immunocompromised) people causes either no symptoms or mild symptoms and those infected never seek medical care; when symptoms are more pronounced, they usually present as lung problems (cough, shortness of breath, sputum production, fever, and chest pains). The disease can progress to chronic or progressive lung disease and may even become disseminated to the skin, brain (meninges), skeleton, and other body areas. The disease can also infect many animal types (for example, dogs, cattle, otters, and monkeys).

Most microbiologists and infectious disease physicians prefer the name coccidioidomycosis because the word describes the disease as a specific fungal disease, and this term may replace valley fever in the future. This disease has several commonly used names (valley fever, San Joaquin Valley fever, California valley fever, acute valley fever, and desert fever). Other names get confused with valley fever (for example, rift or African valley fever, which is caused by a virus).

Coccidioidomycosis was first noted in the 1890s in Argentina; tissue biopsies of people with the disease showed pathogens that resembled coccidia (protozoa). During 1896-1900, investigators learned the disease was caused by a fungus, not protozoa, so the term "mycosis" was eventually added to "coccidia." The disease is often noted to occur in outbreaks, usually when soil is disturbed and dust arises, and when groups of people visit an endemic region (such as San Joaquin Valley or Bakersfield, California, and Tucson, Arizona, or parts of southern New Mexico or west Texas) during late summer and early fall. The disease is not transmitted person to person; it is acquired from the environment via contaminated soil and dust. About 100,000 cases are diagnosed each year in the U.S.