Coccidioidomycosis

Coccidioides is a genus of dimorphic fungi made up of 2 separate species: Coccidioides immitis and Coccidioides posadasii. The 2 species, endemic to arid regions of Mexico, Central and South America, and the southwestern United States, lead to clinically indistinguishable infections. The incidence of disease from these species has increased markedly since 1998, particularly in Arizona and California. Most infections occur through inhalation, whereas person-to-person transmission is rare. Coccidioides has been reported to be the cause of 15% to 29% of community-acquired pneumonia in endemic regions. Clustering of coccidioidomycosis can occur around dust-generating events, such as storms, recreational activity, or occupational exposures that cause aerosolization of soil. For a patient with clinical criteria consistent with coccidioidomycosis, a thorough travel history should be obtained because even short visits to an endemic region can provide sufficient exposure to cause infection. Patients who are immunocompromised, people of Filipino or African American descent, women...