TCHB
09-30-2007, 02:02 PM
What are the symptoms?
Most cases of Valley Fever are very mild. It is thought that over 60% of infected people have either no symptoms or experience flu-like symptoms and never seek medical attention. Of those patients seeking medical care, the most common symptoms are fatigue, cough, chest pain, fever, rash, headache and joint aches. Some people develop painful red bumps on their shins or elsewhere that gradually turn brown (the medical term for these is erythema nodosum). These symptoms are not unique to Valley Fever and can be caused by other illnesses. Therefore, identifying Valley Fever as the cause of illness requires specific laboratory tests.
Most commonly reported symptoms:
fatigue,
cough,
chest pain,
fever,
rash,
headache and
joint aches
The usual course of disease in otherwise healthy people is complete recovery within six months. In most cases, the bodys immune response is effective and no specific course of treatment is necessary. About 5% of cases of Valley Fever pneumonia (infection of the lungs) result in the development of nodules in the lung. These are small residual patches of infection that generally appear as solitary lesions, typically one to one and a half inches in diameter, and often produce no symptoms. On a chest x-ray, these nodules resemble lung cancer. Unfortunately, it is usually not possible to make a definite diagnosis without removing a part or all of the nodule by bronchoscopy, needle-aspiration or surgery.
Another five percent of patients develop lung cavities after their initial infection with Valley Fever. These cavities occur most often in older adults, usually without symptoms, and about 50% of them disappear within two years. Occasionally, these cavities rupture, causing chest pain and difficulty breathing, and require surgical repair.
Range of cases:
inapparent: 60%;
mild to moderate: 30%;
complications: 510%;
and fatal: <1%.
Of those patients with Valley Fever that seek medical attention, 12% develop disease that has spread (disseminated) to other parts of the body. The most common site of dissemination is the skin. Biopsies of skin lesions may reveal Coccidioides immitis when grown in culture. Bones and joints (especially the knees, vertebrae, and wrists) are other frequent sites of dissemination. The changes in bones and joints due to Valley Fever infection can be seen on x-rays and in CT-scans of the affected body part. Meningitis is the most serious and lethal complication of disseminated disease. Symptoms include headache, vomiting, stiff neck, and other central nervous system disturbances. A spinal tap is required for a definite diagnosis of meningitis.
TABLE OF CONTENTS
How is Valley Fever diagnosed?
A diagnosis of coccidioidomycosis is suspected only if a patient is known to have had exposure to the disease through travel or residence in an endemic area. Diagnosis can be confirmed by (1) microscopic identification of the fungal spherules in an infected tissue, sputum or body fluid sample, (2) growing a culture of Coccidioides immitis from a tissue specimen, sputum or body fluid and (3) detection of antibodies (serological tests specifically for Valley Fever) against the fungus in blood serum or other body fluids. Valley Fever skin tests* (called coccidioidin or spherulin) indicate prior exposure to the fungus, but, because reactivity is lifelong, skin tests are not particularly helpful in diagnosing a current infection. Commonly, a routine chest x-ray will detect Valley Fever cavities in a person with no symptoms and who may be unaware of ever having had Valley Fever. While positive blood test (serological) results almost always mean that a patient has Valley Fever, a third or more of patients with Valley Fever may actually have negative results. Therefore, it may be necessary to repeat the serologies periodically.
Most cases of Valley Fever are very mild. It is thought that over 60% of infected people have either no symptoms or experience flu-like symptoms and never seek medical attention. Of those patients seeking medical care, the most common symptoms are fatigue, cough, chest pain, fever, rash, headache and joint aches. Some people develop painful red bumps on their shins or elsewhere that gradually turn brown (the medical term for these is erythema nodosum). These symptoms are not unique to Valley Fever and can be caused by other illnesses. Therefore, identifying Valley Fever as the cause of illness requires specific laboratory tests.
Most commonly reported symptoms:
fatigue,
cough,
chest pain,
fever,
rash,
headache and
joint aches
The usual course of disease in otherwise healthy people is complete recovery within six months. In most cases, the bodys immune response is effective and no specific course of treatment is necessary. About 5% of cases of Valley Fever pneumonia (infection of the lungs) result in the development of nodules in the lung. These are small residual patches of infection that generally appear as solitary lesions, typically one to one and a half inches in diameter, and often produce no symptoms. On a chest x-ray, these nodules resemble lung cancer. Unfortunately, it is usually not possible to make a definite diagnosis without removing a part or all of the nodule by bronchoscopy, needle-aspiration or surgery.
Another five percent of patients develop lung cavities after their initial infection with Valley Fever. These cavities occur most often in older adults, usually without symptoms, and about 50% of them disappear within two years. Occasionally, these cavities rupture, causing chest pain and difficulty breathing, and require surgical repair.
Range of cases:
inapparent: 60%;
mild to moderate: 30%;
complications: 510%;
and fatal: <1%.
Of those patients with Valley Fever that seek medical attention, 12% develop disease that has spread (disseminated) to other parts of the body. The most common site of dissemination is the skin. Biopsies of skin lesions may reveal Coccidioides immitis when grown in culture. Bones and joints (especially the knees, vertebrae, and wrists) are other frequent sites of dissemination. The changes in bones and joints due to Valley Fever infection can be seen on x-rays and in CT-scans of the affected body part. Meningitis is the most serious and lethal complication of disseminated disease. Symptoms include headache, vomiting, stiff neck, and other central nervous system disturbances. A spinal tap is required for a definite diagnosis of meningitis.
TABLE OF CONTENTS
How is Valley Fever diagnosed?
A diagnosis of coccidioidomycosis is suspected only if a patient is known to have had exposure to the disease through travel or residence in an endemic area. Diagnosis can be confirmed by (1) microscopic identification of the fungal spherules in an infected tissue, sputum or body fluid sample, (2) growing a culture of Coccidioides immitis from a tissue specimen, sputum or body fluid and (3) detection of antibodies (serological tests specifically for Valley Fever) against the fungus in blood serum or other body fluids. Valley Fever skin tests* (called coccidioidin or spherulin) indicate prior exposure to the fungus, but, because reactivity is lifelong, skin tests are not particularly helpful in diagnosing a current infection. Commonly, a routine chest x-ray will detect Valley Fever cavities in a person with no symptoms and who may be unaware of ever having had Valley Fever. While positive blood test (serological) results almost always mean that a patient has Valley Fever, a third or more of patients with Valley Fever may actually have negative results. Therefore, it may be necessary to repeat the serologies periodically.