Coccidioidomycosis

Coccidioidomycosis is a systemic disease caused by Coccidioides immitis and C posadasii spp, which are predominant in arid zones of the American continent, mainly in the Southwestern United States and the northern states of Mexico, as well as other regions with different environmental conditions. Some countries of Central and South America are also endemic zones. Most infected patients are asymptomatic. Disseminated disease develops in less than 5% of clinically affected individuals. Culture, biopsy, and DNA probes are used for fungus identification. Prognosis is related to low antibody detection and a positive intradermic skin reaction to coccidioidin. Immunodepressed patients and pregnant women require special attention in diagnosis, therapy, and prognosis. Amphotericin B in its different forms, itraconazole, and fluconazole, are the most frequently used treatments. Posaconazole and voriconazole are prescribed in some unresponsive cases. (C) 2012 Elsevier Inc. All rights reserved.