Valley Fever

Valley fever is a disease caused by tiny fungi called coccidioides. These fungi live in the soil in certain parts of the world. When the soil is disturbed, like during farming, construction, or by strong winds, the fungi's spores are released into the air. If you breathe these spores in, they can infect your lungs, causing valley fever. This is also sometimes called acute coccidioidomycosis.

Valley fever often has symptoms like a fever, cough, and feeling tired. Most cases are mild and get better on their own. But, in some more serious cases, doctors may prescribe antifungal medicines to help the body fight the infection.

Valley fever is a type of infection called coccidioidomycosis. It often starts as a relatively mild illness, sometimes called acute coccidioidomycosis. However, in some cases, this initial infection can progress to a more serious form, like chronic coccidioidomycosis or disseminated coccidioidomycosis. These more serious forms of the disease involve more of the body and can last longer.

If you're over 60, have a weakened immune system, are pregnant, or are of Filipino or African descent, and you start experiencing valley fever symptoms, it's important to get medical help right away. Valley fever is a disease that can be serious, and prompt medical attention is key. This is especially true if:

• You live in an area where valley fever is common, or recently traveled there: The risk of getting valley fever is higher if you're exposed to the fungus that causes it. If you've been in an area known for valley fever, your risk is increased.

• Your symptoms aren't getting better: If your symptoms, like fever, cough, or body aches, aren't improving, or are getting worse, it's crucial to see a doctor. A doctor can properly diagnose the issue and get you the right treatment.

Make sure to tell your doctor if you've visited a place where valley fever is common and you're experiencing symptoms. This information helps your doctor make an accurate diagnosis and develop the best plan for your care.

Valley fever is a fungal infection that happens when you breathe in tiny spores from the ground. These spores come from specific types of fungi, Coccidioides immitis or Coccidioides posadasii. These fungi live in the soil of parts of the southwestern United States, including Arizona, Nevada, Utah, New Mexico, California, Texas, and Washington. The name "valley fever" comes from the San Joaquin Valley in California, where it was first recognized. You can also find these fungi in parts of northern Mexico and Central and South America.

These fungi, like many others, have a specific life cycle. In the soil, they grow like a mold, with thread-like structures. When the soil is disturbed, these thread-like structures break off into tiny, dust-like spores. These spores are released into the air. If you breathe them in, the spores can travel to your lungs.

These spores are very small, so the wind can easily carry them long distances. Once inside your lungs, the spores begin to multiply, continuing the infection process.

Valley fever, caused by inhaling certain fungi, can affect anyone, but some people are more likely to get seriously ill. Here are some factors that increase the risk:

1. Where you live and work: If you live in an area where these fungi are common, especially if you spend a lot of time outdoors, you're more vulnerable. This includes people working in jobs that involve dust, like construction, road work, farming, ranching, archaeology, or military training exercises. Essentially, any job or activity that brings you into contact with soil or dust where these fungi might be present increases your risk.

2. Your background: Unfortunately, some racial and ethnic groups, like people of Filipino and African descent, seem to be more susceptible to serious valley fever infections. Scientists are still researching why this is the case.

3. Pregnancy and new motherhood: Women who get valley fever during their third trimester of pregnancy or shortly after giving birth may have a higher risk of a severe infection. This is because their bodies are going through significant changes at these times.

4. A weakened immune system: If your immune system isn't working as well as it should, you're more likely to develop complications from valley fever. This can be caused by several things, including: * HIV/AIDS: People with weakened immune systems from HIV/AIDS are at a higher risk. * Medications: Certain medications like steroids, chemotherapy, and drugs to prevent organ rejection after a transplant can weaken the immune system. * Autoimmune diseases: Some autoimmune diseases, like rheumatoid arthritis or Crohn's disease, and the medications used to treat them (like TNF inhibitors) can also increase the risk.

5. Diabetes: People with diabetes might have a harder time fighting off the infection and could experience more severe lung problems if they get valley fever.

6. Age: Older adults are more likely to have complications from valley fever. This is often because their immune systems are not as strong as they once were, or they might have other health problems that make them more vulnerable.

It's important to remember that these are risk factors, not guarantees. Many people exposed to the fungi never develop valley fever. If you have concerns about valley fever, talk to your doctor.

Coccidioidomycosis, sometimes called Valley Fever, can be a serious illness, especially for certain groups. Some people, including pregnant women, those with weakened immune systems (like people with HIV/AIDS), and people of Filipino or African descent, are more likely to have a harder time fighting it off and develop a more severe form.

This fungal infection can lead to several potential problems:

• Severe Lung Infection (Pneumonia): Most people who get coccidioidomycosis pneumonia recover without any lasting issues. However, some, like those with weakened immune systems or certain ethnic backgrounds, might get very sick. This severe pneumonia can fill the lungs with fluid, making it difficult to breathe. Medical treatment is usually needed to help the lungs heal.

• Lung Cavities and Rupture: In some cases, small, thin-walled pockets (nodules or cavities) can form in the lungs. Many of these heal on their own. But if one of these cavities bursts (ruptures), it can cause chest pain and trouble breathing. In these situations, a tube might be inserted to drain the air, or surgery might be needed to fix the damage.

• Spread Throughout the Body (Disseminated Disease): This is the most serious complication, but it's not very common. Sometimes, the fungus can spread to other parts of the body. If this happens, it can cause a variety of problems, including: sores on the skin (ulcers), pus-filled pockets (abscesses), damage to bones, intense joint pain, inflammation of the heart, problems with the urinary system, and even meningitis (a serious infection of the membranes surrounding the brain and spinal cord). Meningitis can be life-threatening.

If you have concerns about coccidioidomycosis or experience symptoms like fever, cough, or chest pain, it's important to see a doctor right away. Early diagnosis and treatment are crucial to prevent complications.

Valley fever has no vaccine. If you live in or travel to places where valley fever is a concern, taking precautions is important, especially after a rainy season, when the risk is higher. This is because the fungus that causes valley fever often spreads in the dry, dusty conditions that follow.

To protect yourself, consider these everyday steps:

• Cover your face: Wear a mask, especially when outside. This will help block the tiny fungus particles that can cause the infection.

• Stay away from dust: Avoid places with lots of dust, like construction sites. If you must be in dusty areas, try to limit your time there.

• Shelter from storms: If there's a dust storm, stay indoors until it passes. This will help keep you from breathing in the fungus-carrying dust.

• Be cautious with soil: If you need to work with soil, wet it first. This reduces dust. If you're at higher risk for valley fever (for example, if you have a weakened immune system), avoid working with soil altogether.

• Keep your home sealed: Close your doors and windows to prevent dust from entering your home.

• Take care of cuts and scrapes: Clean any skin cuts or scrapes thoroughly with soap and water. This will help prevent infection.

By taking these simple precautions, you can lower your risk of getting valley fever.

Diagnosing valley fever can be tricky because the symptoms are often mild and similar to other illnesses. This makes it hard to know if you have valley fever just by looking at your symptoms. Even a chest X-ray might not be enough to tell the difference between valley fever and other lung infections, like pneumonia.

Doctors use several methods to confirm a valley fever diagnosis. They'll first review your medical history and look for any patterns in your symptoms. Since symptoms can be vague, they often need more than just symptoms to make a diagnosis.

To get a clearer picture, doctors might order some tests. These tests can help them identify the cause of your symptoms.

• Imaging tests: If pneumonia is a possibility, doctors might order a CT scan, MRI, or chest X-ray to look for signs of infection in your lungs. These tests create detailed images of your body's internal structures.

• Tissue sample: Sometimes, a small sample of lung tissue is taken to be examined under a microscope. This allows the doctor to look for the fungus that causes valley fever.

• Skin test: A skin test can reveal if you've had valley fever before and developed immunity. This test involves injecting a small amount of a substance related to the fungus into your skin. If you've had the infection, your body will react to it.

• Sputum tests: A sample of your phlegm (sputum) can be tested to see if the fungus that causes valley fever is present. This involves looking at the sputum under a microscope or growing the fungus in a lab.

• Blood tests: Blood tests can help doctors find antibodies in your blood that are created by your body to fight off the valley fever fungus. If the blood test shows these antibodies, it suggests you might have the infection.

These various tests help doctors to accurately diagnose valley fever and determine the best course of treatment.

Valley fever is usually treated with supportive care, and sometimes medicine.

Many people with a short-term case of valley fever don't need any medicine. Doctors still watch these individuals closely.

However, if symptoms don't get better, last a long time, get worse, or if you have a higher chance of complications, your doctor might prescribe an antifungal medicine. Antifungal medications are also used if the disease is ongoing (chronic) or has spread throughout the body (disseminated).

Common antifungal medicines for valley fever (coccidioidomycosis) include fluconazole (brand name Diflucan) and itraconazole (brand names Sporanox and Tolsura). These are usually enough for most cases, except the most severe.

All antifungal medicines can cause side effects. But these side effects often go away when you stop taking the medicine. Possible side effects of fluconazole and itraconazole include nausea, vomiting, stomach pain, and diarrhea. Fluconazole can also cause hair loss, dry skin, dry mouth, and chapped lips.

More serious cases of valley fever might first be treated with an antifungal medicine given directly into a vein (intravenously). An example of this type of medicine is amphotericin B (various brand names).

Three newer antifungal medicines—voriconazole (Vfend), posaconazole (Noxafil), and isavuconazonium sulfate (Cresemba)—might also be used for more severe infections.

For most people, having valley fever once usually gives them lifelong protection. But the disease can come back (reactivate) or you can get it again if your immune system is very weak.