Coccidioidomycosis is a fungal infection acquired by inhalation of the spores of Coccidioides immitis, usually in wind-borne dust particles. C immitis is a soil saprophyte found in the southwestern United States, Mexico, and Central and South America. With the increase in tourism to endemic areas has come an increase in the number of infections that are carried home to other locations. Therefore, even physicians in nonendemic regions need to be able to recognize and evaluate this disease. Most patients with coccidioidomycosis are not seen by a physician.
Rashes are common and include toxic erythema, erythema nodosum, and erythema multiforme.
Diagnosis of coccidioidomycosis is made with microscopy, culture, or immunologic testing. Two antibody responses are available in diagnosis and evaluation. CFA occurs later in the course of the disease and may remain present for years. An elevated CFA titer is highly suggestive of systemic dissemination, except in central nervous system disease. Although there are no racial or sex differences in susceptibility to the primary infection, there are differences in risk of dissemination.