Coccidioidomycosis: Recognizing the varied clinical presentations

Although coccidioidomycosis is often asymptomatic, it can have a variety of manifestations, including acute and chronic respiratory disease, osteoarticular destruction, and meningitis. The incidence of coccidioidomycosis is increasing as a result of travel and the influx of susceptible persons into the southwestern United States, where the fungal pathogens - Coccidioides immitis and Coccidioides posadasii - are endemic. Diagnostic methods include culture, serology, histopathological examination, and antigen detection, but all have limited sensitivity. Coccidioidomycosis can be successfully treated with azoles and amphotericin B; however, a prolonged duration of treatment may be required, relapse is common, and permanent disability and death may occur.