Coccidioidomycosis

• Epidemiology:
  • endemic to SW U.S., Central and South America
• Clinical manifestations
  • Acute:
    • subclinical PNA,
    • arthralgias,
    • rash (erythema nodosum)
  • Chronic lung disease (seen in immunosupp):
    • dyspnea,
    • chest pain,
    • hemoptysis, “B” sx
  • Disseminated (immunosupp, pregnant):
    • meningitis,
    • osteo,
    • monoarthritis,
    • cutaneous
• Treatment:
  • no Rx for mild PNA in immunosupp.;
  • ampho for severe/CNS involvement;
  • azoles for extrathoracic w/o CNS involvement;
  • some cases require debridement