Valley Fever

Valley Fever is an infection caused by a fungus - coccidiodes imitis.  The fungus in located mainly in the southwest and in Arizona in particular.  The fungus is normally found in the soil.  When the soil is disturbed by wind or construction, the fungus becomes airborne and may enter the lungs.  When a person inhales the fungus, the vast majority of the time the body’s immune system prevents any infection from developing.  Occasionally pneumonia may result.  Usually this is a mild form of pneumonia that may not even be recognized as anything more than a “cold.”  Cough and fatigue are common.  In certain people, the pneumonia is not well controlled by the body’s immune system, and the infection may become more serious leading to symptoms of shortness of breath.  The fungus may even spread outside the lungs.  This is called dissemination.  The most common sites of spread are to the bones, skin and central nervous system (brain and adjacent tissues).  In patients with an impaired immune systems, the infection may become life threatening. 

Valley Fever can be difficult to diagnose.  There are blood tests that can help.  However, these tests are not 100% accurate.  You can have the disease and have a negative blood test.  Biopsy or culture of involved tissue is the most accurate way to make a certain diagnosis.  In the lungs, this is usually done by bronchoscopy or needle biopsy of a mass.  For patients with a positive blood test, we will follow this test over time to help guide your treatment.

Valley Fever is a great mimicker of other diseases.  It may cause pneumonia-like symptoms, fever, fatigue and headache.  It may look very much like a cancer on X-rays.  It can cause seizures and other brain problems when it spreads to the central nervous system.  Valley Fever cannot be passed from one person to the next.

Most people that develop a mild form of Valley Fever do not need treatment.  However, if your immune system is impaired or you are pregnant or from certain parts of the world, your doctor may choose to treat you as certain groups of people are at higher risk of developing a more serious disease.  Treatment duration varies depending on what type of disease you have.  If the infection has spread outside the lungs, then medications are continued for 1-2 years and in some cases indefinitely.  For mild limited infection of the lungs, either no treatment is prescribed or 1-2 weeks of antifungal medication.  Fluconazole is the first line therapy for most people.  This drug has certain interactions, and you should be sure to tell your physician about all the medications you are taking. 

The lung and infectious disease doctors at Arizona Pulmonary Specialists are experts in the diagnosis and treatment of Valley Fever.   Our team of doctors, nurses and respiratory therapists will work with you to ensure that you understand your medications and other treatments.