Overview of Disseminated Coccidioidomycosis

Signs and Symptoms

There are many acute infections such as disseminated coccidioidomycosis that cause little or no symptoms. Some symptoms that are experienced generally range from very mild to severe. These symptoms and signs include a fever, cough, chills and headache as well as musclepain, muscle stiffness and shoulder or neck stiffness. Also a change in the mental status of the patient or sensitivity to bright light is considered symptoms. Joint swelling and pain along with arthritis, swelling of the ankle, leg and feet as well as a skin reaction known as erythema nodosum are symptoms found with this disease.

Diagnoses

Diagnosis would include many tests such as a chest x-ray, complete blood count with differentials, a sputum KOH test, coccidioidin skin tests, coccidioides complement fixation titers and sputum cultures are done. Also, biopsy of the affected tissues can be done including bone marrow, liver, open lung biopsies and a biopsy of the skin lesions have been successful in the past.

Treatment of Disseminated Coccidioidomycosis

Treatment of disseminated coccidioidomycosis includes bed rest and an improved diet. Antifungal drugs are normally given to treat this infection such as fluconazole, ketoconazole, amphotericin B and caspofungin. Diets high in fiber and low in sugars are recommended to help boost the immune system as well as an increase in vitamins. When immune system therapy is introduced, the disease normally will start to wither and symptoms will decrease drastically.

The most important aspect of treatment is to continue with the treatment for as long as prescribed, as the infection can return if the entire schedule of medication is not taken. Simply taking the medication until the symptoms are gone will help the infection to build up immunity to the medication and therefore makes the medicines less effective. When and if a secondary round of medications is given, it would be a stronger antifungal and would have higher risk of side effects.

Risks or Possible Complications

Risks of disseminated coccidioidomycosis include having diabetes, a suppressed immune system, being pregnant, having a lymphoma or even TNF inhibitor drugs such as steroids or chemotherapy drugs. Each of these diseases carries the risk of being exposed to this disease, as the immune system is affected and becomes weaker. Pregnant women are generally the lowest numbers of patients, especially when prenatal vitamin regiments are followed with regular checkups. Complications would include the infection spreading into the lungs, liver, bones, brain, heart and skin as well as meningitis forming due to the progression of the infection and lack of treatments or not finishing treatments prescribed.

Resources

MedlinePlus.com - Coccidioidomycosis - disseminated

Center for Disease Control and Prevention - Emerging Infectious Diseases