How I Treat Coccidioidomycosis

Abstract

Coccidioides immitis and C. posadasii are pathogenic dimorphic fungi responsible for causing coccidioidomycosis in the southwestern part of United States. Incidence of this disease continues to rise in endemic areas. Coccidioidomycosis starts as a respiratory illness and in less than 5 % of cases disseminates to other anatomic sites. Patient management requires careful periodic assessment. Some patients require no therapy, while others require antifungal medications for several months, or in some cases, indefinitely. Factors that influence the decision to treat include degree and duration of patient symptoms, radiographic findings, anti-complementary titers, immunosuppression and comorbidites. Cure for disseminated infection appears to be an unreachable goal with current treatments.