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Coccidioidomycosis - chronic pulmonary

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Definition:

Chronic pulmonary coccidioidomycosis is a lung infection caused by breathing in the fungus coccidioides. This fungus is found in the soil in certain parts of the southwestern U.S., Mexico, and Central and South America.

Causes, incidence, and risk factors:

The infection is caused by breathing in the spores of a fungus found in desert regions such as Arizona or California's San Joaquin Valley. The disease can have an acute , chronic , or disseminated form.

The chronic form usually develops after a period of months to years following a harmless infection that may have gone undiagnosed. Lung abscesses may form and may rupture into the pleural spaces causing empyema (pus in the pleural space) or bronchopleural fistula. Scarring (fibrosis) and cavities may gradually form in the upper lungs as the chronic form of coccidioidomycosis slowly progresses over months to years.

Still, the majority of pulmonary coccidioidomycosis infections do not become chronic. In fact, the majority of infections cause no symptoms and are only recognized by a positive coccidioidin skin test .

Dark-skinned people and people with a weak immune system are more susceptible to infection and more likely to form chronic or disseminated (spreading to other organs) forms of the disease.

References:

Chiller TM. Coccidioidomycosis. Infect Dis Clin North Am . 2003; 17(1): 41-57, viii.

Murray J, Nadel J. Textbook of Respiratory Medicine . 3rd ed. Philadelphia, Pa: WB Saunders; 2000.

Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases . 5th ed. London, UK: Churchill Livingstone; 2000:2746-2755.

Galgiani JN, Ampel N, Blair JE, et al. Coccidioidomycosis. Clin Infect Dis . 2005;41:1217-23.

• Review Date: 8/10/2005
• Reviewed By: David A. Kaufman, M.D., Assistant Professor, Division of Pulmonary, Critical Care & Sleep Medicine, Mount Sinai School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.

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