Overview
Valley fever, also known as coccidioidomycosis, is a fungal infection caused by inhaling spores of the fungi Coccidioides immitis or Coccidioides posadasii. These fungi are found in soil in certain regions, such as Arizona, Nevada, Utah, New Mexico, California, Texas, and Washington, as well as in northern Mexico and Central and South America. When the soil is disturbed, the fungi release spores that can be inhaled by people, continuing the disease cycle once inside the lungs. Valley fever can lead to a range of symptoms, including painful lesions in the skull, spine, or other bones, painful, swollen joints, especially in the knees or ankles, and meningitis, an infection of the membranes and fluid surrounding the brain and spinal cord. The disease primarily affects people with weakened immune systems, those over 60, pregnant individuals, and those of Filipino or African heritage. If you have symptoms and have traveled to an area where valley fever is common or live in such an area, it's important to seek medical care.
Understanding the disease
Symptoms
The symptoms of valley fever include painful lesions in the skull, spine, or other bones, painful, swollen joints, especially in the knees or ankles, and meningitis, which is an infection of the membranes and fluid surrounding the brain and spinal cord. Other symptoms may include fever, chills, headache, muscle aches, dry cough, chest pain, tiredness, and symptoms associated with a mild fever of 102 F (38.9 C) or lower. Valley fever may also cause a fine, pink rash that begins on the face and quickly spreads to the trunk and then the arms and legs, before disappearing in the same order, as well as aching joints, especially in young women. It's important to seek medical care if you develop these symptoms, especially if you are over 60, have a weakened immune system, are pregnant, or are of Filipino or African heritage and have recently traveled to or live in an area where the disease is common.
Risk Factors
The risk factors for developing valley fever include:
- Environmental exposure: Anyone who inhales the spores that cause valley fever is at risk of infection, especially those who live in areas where the fungi are common, spend a lot of time outdoors, or have jobs that expose them to dust.
- Age: Older adults are more likely to develop valley fever, possibly due to a less robust immune system or underlying health conditions.
- Weakened immune system: People with a weakened immune system, such as those living with HIV/AIDS, undergoing chemotherapy or steroid treatment, or taking anti-rejection drugs after transplant surgery, are at an increased risk of serious complications.
- Pregnancy: Pregnant women in the third trimester and new mothers are vulnerable to more-serious infections.
- Race: People of Filipino and African heritage are more susceptible to developing serious fungal infections.
- Diabetes: People with diabetes may have a higher risk of severe lung infections. It's important to be aware of these risk factors and take necessary precautions to minimize exposure to the valley fever spores.
Development
Valley fever develops when a person inhales spores of certain fungi that cause the infection. The fungi, Coccidioides immitis or Coccidioides posadasii, live in the soil in certain parts of the United States, Mexico, and South America. The spores are extremely small and can be carried far by the wind. Once inside the lungs, the spores reproduce, leading to the disease. There are different ways in which valley fever can develop, depending on factors such as a person's immune system, age, and overall health. In general, people with weaker immune systems or those who are exposed to the fungi for an extended period may be more susceptible to developing severe complications. Symptoms can range from mild to severe, and they can include fever, cough, and fatigue. In some cases, valley fever may lead to chronic lung infections or other serious health issues. It's important to seek medical attention if you suspect you may have valley fever, particularly if you have recently traveled to an area where the fungi are common and are experiencing symptoms. Your doctor can help determine the best course of treatment based on your individual case.
Assessment and Diagnosis
Triage
You should see a doctor if valley fever is suspected, especially if you meet any of the following criteria:
- You are over 60, have a weakened immune system, are pregnant, or are of Filipino or African heritage.
- You develop signs and symptoms of valley fever, such as painful lesions in the skull, spine, or other bones; painful, swollen joints, especially in the knees or ankles; and meningitis (an infection of the membranes and fluid surrounding the brain and spinal cord).
- Your symptoms are not improving or are accompanied by a fever, warm and swollen areas of skin that are full of pus or other drainage, or a red, spotty rash mainly on the lower legs but sometimes on the chest, arms, and back. It is important to seek medical care if you suspect valley fever to ensure proper diagnosis and treatment, especially if you have a weakened immune system or other risk factors.
Diagnosis
To diagnose valley fever, your doctor may evaluate your medical history and review your signs and symptoms. Valley fever is difficult to diagnose based on signs and symptoms because they are usually vague and similar to those in other illnesses. Doctors may order one or more of the following tests:
- Sputum smear or culture: Checks a sample of the matter discharged while coughing for the presence of coccidioides organisms.
- Blood tests: Checks for antibodies against the fungus that causes valley fever.
Management and Treatment
Complications
Complications of valley fever may include severe pneumonia, painful lesions in the skull, spine, or other bones, painful and swollen joints, especially in the knees or ankles, and meningitis (an infection of the membranes and fluid surrounding the brain and spinal cord). These complications are more likely to occur in people with weakened immune systems, such as those living with HIV/AIDS, pregnant women, and those of Filipino or African heritage. It is essential to seek medical care if you have valley fever symptoms and belong to any of these high-risk groups.
Treatment
The best approach to treat valley fever is supportive care. There's no specific cure for valley fever, and antiviral medications like ribavirin might only shorten the course of some infections and prevent complications in some cases. Supportive care is essential to prevent dehydration, and it may involve fluids to help maintain your balance of electrolytes.
Preparing for medical consultation
To prepare for an appointment for valley fever, follow these steps:
- Be aware of any pre- or post-appointment restrictions: Ask your healthcare provider if there are any restrictions you need to follow in the time leading up to your visit,