Valley Fever (Coccidioidomycosis)

  • Medical Author:
    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.

  • Medical Editor: Melissa Conrad Stöppler, MD
    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.

What is the treatment for valley fever (coccidioidomycosis)?

The majority of cases (over 60%) spontaneously resolves and requires no treatment. However, there are several antifungal drugs available to treat coccidioidomycosis if needed. The drug of choice is usually amphotericin B, but oral azoles (fluconazole [Diflucan], itraconazole [Sporanox], and ketoconazole [Nizoral]). Newer antifungal agents including posaconazole and voriconazole are often used "off label," meaning they have not been approved to treat coccidioidomycosis. Most of these drugs have side effects, and most have not been proven safe to use in pregnant patients except for amphotericin B. High relapse rates can occur with some patients (about 75% relapse with brain involvement), requiring lifelong antifungal therapy. In general, dosage (especially pediatric), length of time of drug administration, and the choice of drug is best decided in consultation with an infectious disease specialist.

Surgical treatment is sometimes needed. Pulmonary cavities, persistent pulmonary infection, empyema (pus collection), and shunt placement are some of the surgical interventions used to treat this disease.

Other treatments (for example, prednisone [Deltasone, Liquid Pred] or alternative therapy such as dietary modification) are not currently recommended by most physicians; people should consult with their physician before trying to use such methods.

Medically Reviewed by a Doctor on 3/18/2016

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