Valley Fever – What is it, Symptoms and Treatments!

Valley Fever – What it is, Symptoms and Drug Treatments. In addition, Valley Fever is a fungal infection caused by coccidioid organisms (kok-sid-e-OY-deze). It can cause fever , chest pain, and cough, among other signs and symptoms. Two species of coccidioid fungi cause Valley Fever .

These fungi are commonly found in the soil in specific regions. Fungal spores can be stirred into the air by anything that disturbs the soil, such as agriculture, construction, and wind. The fungi can then be breathed into the lungs and cause Valley Fever , also known as acute coccidioidomycosis (kok-sid-e-oy-doh-my-KOH-sis).

Mild cases of Valley Fever usually resolve on their own. In more severe cases, doctors prescribe antifungal medications that can treat the underlying infection.

Causes of Valley Fever:  The fungi that cause Valley Fever – Coccidioides imitis or Coccidioides posadasii – thrive in the arid desert soils of southern Arizona, Nevada, northern Mexico and the San Joaquin Valley of California. They are also endemic to New Mexico, Texas and parts of Central and South America – areas with mild winters and arid summers.

Like many other fungi, coccidioid species have a complex life cycle. In the soil, they grow like a mold with long filaments that break into spores in the air when the soil is disturbed. The spores are extremely small and can be carried hundreds of kilometers by the wind. Once inside the lungs, the spores reproduce, perpetuating the disease cycle.

Symptoms of Valley Fever: Valley  Fever is the initial form of coccidioidomycosis infection. This initial, acute illness can develop into a more serious illness, including chronic and disseminated coccidioidomycosis.

Acute Coccidioidomycosis ( Valley Fever ): The initial or acute form of coccidioidomycosis is usually mild with few, if any, symptoms. When signs and symptoms do occur, they appear one to three weeks after exposure. They tend to resemble those of the flu, and can range from minor to severe, including:

• Fever
• Cough
• Chest pain
• Goosebumps
• night sweat
• Headache
• Fatigue
• common pains
• red, rash

The rash that sometimes accompanies Valley Fever is made up of painful red bumps that can turn brown. The rash appears mostly on the legs, but sometimes on the chest, arms, and back. Others may have a red rash with blisters or a rash that looks like pimples.

If you do not get sick from Valley Fever , you may only find out that you have been infected when you later have a positive skin or blood test or when small areas of residual infection (nodules) in the lungs show up on a routine chest X-ray. Although nodules usually don’t cause problems, they can look like cancer on X-rays.

If you develop symptoms, especially severe ones, the course of the disease is highly variable. It can take months to fully recover, and fatigue and joint pain can last even longer. The severity of the illness depends on several factors, including your general health and the number of fungal spores you inhale.

Chronic Coccidioidomycosis:  If the initial coccidioidomycosis infection does not resolve completely, it can progress to a chronic form of pneumonia. This complication is more common in people with weakened immune systems. Signs and symptoms include:

• low fever
• Weight loss
• Cough
• Chest pain
• Bloody sputum (matter discharged during coughing)
• Nodules in the lungs

Disseminated Coccidioidomycosis:  The most serious form of the disease, disseminated coccidioidomycosis, occurs when the infection spreads (spreads) beyond the lungs to other parts of the body.

Most often, these parts include the skin, bones, liver, brain, heart, and the membranes that protect the brain and spinal cord (meninges). The signs and symptoms of disseminated disease depend on which parts of your body are affected and may include:

• Nodules, ulcers, and skin lesions that are more severe than the rash that sometimes occurs with other forms of the disease
• Painful injuries to the skull, spine, or other bones
• Painful, swollen joints, especially in the knees or ankles
• Meningitis – an infection of the membranes and fluid around the brain and spinal cord

When to See a Doctor:  Seek medical care if you are over 60, have a weakened immune system, are pregnant, or are Black or Filipino, and you develop the signs and symptoms of Valley Fever , especially if you:

• Living or recently traveling to an area where this disease is common
• Have symptoms that aren’t getting better

Be sure to inform your doctor if you have traveled to a place where Valley Fever is endemic and you have symptoms.

Valley Fever Risk Factors:  Here are the main risk factors for Valley Fever :

• Environmental exposure. Anyone who inhales the spores that cause Valley Fever is at risk of infection. People who have jobs that expose them to dust are most at risk: construction, road and agricultural workers, farmers, archaeologists and military personnel in field exercises.
• Running. For reasons that are not well understood, Filipinos, Hispanics, blacks, and Native Americans are more likely to develop a serious infection with coccidioidomycosis than whites.
• Pregnancy. Pregnant women are vulnerable to more serious coccidioidomycosis during the third trimester, and new mothers are vulnerable soon after their babies are born.
• Weakened immune system. Anyone with a weakened immune system is at increased risk of serious complications. This includes people living with AIDS or treated with steroids, chemotherapy and anti-rejection drugs after transplant surgery. People with certain autoimmune diseases, such as rheumatoid arthritis or Crohn’s disease , who are being treated with antitumor necrosis factor (TNF) drugs are also at an increased risk of infection.
• Was. Older adults are more likely to develop Valley Fever . This could be because their immune systems are less robust or because they have other medical conditions that affect their overall health.

Complications of Valley Fever:  Some people, especially pregnant women, people with weakened immune systems – such as those living with HIV/AIDS – and those of Filipino, Hispanic, African or Native American descent are at risk of developing a more severe form of coccidioidomycosis. Complications of coccidioidomycosis can include:

• Severe pneumonia. Most people recover from coccidioidomycosis-related pneumonia without complications. Others, particularly Filipinos, Hispanics, Blacks, Native Americans, and those with weakened immune systems, can become seriously ill.
• Rupture of pulmonary nodules. A small percentage of people develop thin-walled nodules (cavities) in their lungs. Many of them eventually go away without causing any problems, but some can rupture, causing chest pain and making it difficult to breathe. A broken lung lump may require placement of a tube in the space around the lungs to remove air or surgery to repair the damage.
• Disseminated disease. This is the most serious complication of coccidioidomycosis. If the fungus spreads (spreads) throughout the body, it can cause problems ranging from skin ulcers and abscesses to bone injuries, severe joint pain, heart inflammation, urinary tract problems, and meningitis – a potentially fatal infection of the membranes and fluid that covers the brain and spinal cord.

Valley Fever Testing and Diagnosis: Valley  Fever is difficult to diagnose based on signs and symptoms alone because they are often vague and overlap with symptoms that occur in other illnesses. Even a chest X-ray cannot distinguish Valley Fever from other lung diseases.

A definitive diagnosis depends on finding evidence of coccidioid organisms in tissue, blood, or other bodily secretions. For this reason, you are likely to have one or more of the following tests:

• Sputum smear or culture. These tests check a sample of matter that is discharged during coughing (sputum) for the presence of coccidioid organisms.
• Bloodtests. Through a blood test, your doctor can check for antibodies against the fungus that causes Valley Fever .

Valley Fever Treatments:  Rest: Most people with acute Valley Fever do not require treatment. Even when symptoms are severe, the best therapy for otherwise healthy adults is often bed rest and fluids — the same approach used for colds and flu. Still, doctors carefully monitor people with Valley Fever .

Antifungal Medications:  If symptoms do not improve or become worse or if you are at an increased risk of complications, your doctor may prescribe an antifungal medication such as fluconazole. Antifungal medications are also used for people with chronic or disseminated disease.

In general, the antifungal drugs fluconazole (Diflucan) or itraconazole (Sporanox, Onmel) are used for all but the most severe forms   of coccidioidomycosis disease . All antifungals can have serious side effects. However, these side effects usually go away when the medication is stopped. Possible side effects of fluconazole and itraconazole are nausea, vomiting, abdominal pain and diarrhea.

A more serious infection may be treated initially with an intravenous antifungal medication such as amphotericin B (Abelcet, Amphotec, others). Two new drugs — voriconazole and posaconazole (Noxafil) — can also be used to treat more serious infections.

Antifungals control the fungus but sometimes do not destroy it, and relapses can occur. For many people, a single Valley Fever results in lifelong immunity, but the disease  can be reactivated, or you can be reinfected if your immune system is significantly weakened.

Valley Fever  Prevention : If you live in or visit areas where Valley Fever is common, take common sense precautions, especially during the summer months when the chance of infection is highest. Consider wearing a mask, staying inside during dust storms, wetting the soil before digging, and keeping doors and windows tightly closed.