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Coccidioidomycosis - chronic pulmonary

• Overview
• Symptoms
• Treatment
• Prevention

Treatment:

Antifungal medications are prescribed to treat the infection. The intravenous antibiotic, amphotericin B, is used for severe forms of disease. Itraconazole and fluconazole are oral antibiotic options with activity against this fungus. Ketoconazole is another option, but appears less effective. Treating any underlying immunocompromised state (such as AIDS) and minimizing immunosuppressant medications (such as steroids or chemotherapy) is also crucial if the patient's immune system is to properly fight the coccidioidomycosis fungal infection.

Expectations (prognosis):

With treatment the outcome is usually good, although relapses may occur. Some patients, such as those who are immunocompromised (from AIDS or immunosuppressing drugs) may need life-long anti-fungal medication to prevent relapse.

Complications:

• Pleural effusion
• Relapse of infection
• Disseminated coccidioidomycosis
• Coccidioidomycosis meningitis
• Arthritis
• Rash
• Empyema
• Bronchopleural fistula
• Lung scarring (fibrosis)
• Lung cavities

Calling your health care provider:

Call for an appointment with your health care provider if coccidioidomycosis symptoms worsen or do not improve with treatment.

Call your health care provider if new symptoms develop.

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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