Valley fever is a fungal infection most commonly seen in the desert regions of the southwestern United States, and in Central and South America. You get it by breathing in fungal particles from soil. The infection starts in the lungs. Valley fever may also be called coccidioidomycosis. Traveling to an area where the fungus is commonly seen raises your risk for this infection. You are also more likely to develop a serious infection if you have a weakened immune system due to:[i]
The initial, acute form of coccidioidomycosis is often mild, with few, if any, symptoms. When signs and symptoms do occur, they appear one to three weeks after exposure. They tend to resemble those of the flu, and can range from minor to severe: Fever, Cough, Chest pain — varying from a mild feeling of constriction to intense pressure resembling a heart attack, Chills, Night sweats, Headache, Fatigue, Shortness of breath, Joint aches, Red, spotty rash[ii]
There is no vaccine at this time for Valley Fever. Most people are able to fight off Valley Fever on their own without treatment. They usually don't get it again. For those that seek treatment, antifungal drugs (not antibiotics) are used. Although these treatments are often helpful, the disease may persist and years of treatment may be required. If a lung cavity ruptures as mentioned above, surgery may be necessary.[iii]
The majority of cases (over 60%) spontaneously resolves and requires no treatment. However, there are several antifungal drugs available to treat coccidioidomycosis if needed. The drug of choice is usually amphotericin B, but oral azoles (fluconazole [Diflucan], itraconazole [Sporanox], ketoconazole [Nizoral]) and a triazole (posaconazole) can be used. A new drug called voriconazole may also be used. Most of these drugs have side effects, and most have not been proven safe to use in pregnant patients except for amphotericin B. High relapse rates can occur with some patients (about 75% relapse with brain involvement), requiring lifelong antifungal therapy. In general, dosage (especially pediatric), length of time of drug administration, and the choice of drug is best decided in consultation with an infectious disease specialist.
Surgical treatment is sometimes needed. Pulmonary cavities, persistent pulmonary infection, empyema (pus collection), and shunt placement are some of the surgical interventions used to treat this disease.
Other treatments (for example, prednisone [Deltasone, Liquid Pred] or alternative therapy such as dietary modification) are not currently recommended by most physicians; people should consult with their physician before trying to use such methods[iv].
Coccidioidomycosis was first discovered in the early 1890’s in Domingo Ezcurra, an Argentinean soldier. Some pathologists believed his skin conditions were the result of cancer. After tissue biopsies his illness was thought to resemble the protozoan coccidia, often found in chickens. To this day the name of coccidioidomycosis still represents this early misdiagnosis. The Ezcurra case was followed for eleven years and he ultimately died of his illness.
By 1900 coccidioidomycosis was established as a fungal disease. After an outbreak in the 1930’s in the San Joaquin Valley of California, this disease was given its nickname “San Joaquin Valley Fever,” often shortened further to “Valley Fever.” The disease threatened national security during World War II when thousands of American soldiers became sickened while training in the Southwest. It even affects our military today -- as seen during a 2002 Navy Seal training exercise in California when 45% of the squad fell ill. There is still no cure for coccidioidomycosis and no vaccine.[v]