Valley Fever (cont.)

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What is the treatment for valley fever (coccidioidomycosis)?

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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], ketoconazole [Nizoral]) and a triazole (posaconazole) can be used. A new drug called voriconazole may also be used. Caspofungin use has also been reported to treat the infection; it seem to work best in combination with other antifungal drugs. 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 12/8/2014

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