Update on Coccidioidomycosis in the United States and Beyond

Abstract

Coccidioidomycosis is a fungal infection that is prevalent in western United States, Central America, and South America. The infection is acquired by inhalation. It can affect persons of all ages including infants and children. The majority of cases are asymptomatic and the incidence of infection is greater during a dry summer season after heavy rainfall in prior winter. For those with symptoms, they may experience a self-limiting influenza-like illness. However, some may progress toward pneumonia or disseminated diseases involving skeletal system and central nervous system. The diagnosis is based mainly on various serology testing. Antifungal treatment is generally not required for those with mild symptoms. For those with moderate to severe infections, the mainstay of treatment is azole, with fluconazole being often considered as the first line therapy. Currently there is no effective solution to prevent coccidioidomycosis. Those who work in high-risk conditions should be given appropriate protective equipment as well as education on proper precaution.

Current Landscape of Coccidioidomycosis

“…Regions in North America have a longer history of surveillance than Central and South America. It is suggested due to the discrepancy that the impact of CM may be underestimated in Central and South America [5][6][7]. Regions in North America have a longer history of surveillance than Central and South America.…”

“…Since 2002, it has been recognized as two separate species, including the previously categorized C. immitis, and the newer designated C. posadasii [4]. C. immitis mainly resides in California, Washington State, Arizona, and Utah, while C. posadasii is mostly found in Arizona, New Mexico, Texas, Northern Mexico (Baja California, Chihuahua, Nuevo León, Sinaloa, Sonora, and Tamaulipas), and parts of Central (Guatemala and Honduras) and South America (Northern and Central Argentina, Bolivia, Colombia, Northeastern Brazil, Paraguay, and Venezuela) [5][6][7][8] (Figure 1).…”