This is a fungal infection which is caused by coccidioides organisms. This infection can cause coughing, chest pain and fever, among other signs and symptoms. There are 2 species of coccidioides fungi which can cause valley fever. These fungi are commonly found in soil in specific regions. The spores of the fungi can be stirred into the air by anything which disrupts the soil, in which are included wind, construction and farming. These fungi can be breathed into the lungs and they can cause valley fever. Valley fever is also known as acute coccidioidomycosis. When someone has mild case of valley fever, then usually this resolves on its own. When someone has more severe cases, then doctors are prescribing antifungal medications which can treat the underlying infection. [1,2]
Valley fever symptoms
The valley fever is the initial form of coccidioidomycosis infection. This is initial and acute illness which can develop into a more serious disease which is including chronic and disseminated coccidioidomycosis.
- Acute coccidioidomycosis (valley fever): This is the initial or acute form of coccidioidomycosis is often mild and it has few if any symptoms. When signs and symptoms happen, then they appear 1 – 3 weeks after exposure. The signs and symptoms of this condition resemble to those of the flu and they can range from mild to severe. Here are some signs and symptoms:
- Red, spotty rash
- Joint aches
- Night sweats
- Chest pain
There are some cases when the rash accompanies valley fever and it is made up of painful red bumps which may later turn brown. This rash in most cases is appearing on the lower legs but there are some cases when it appears on the back, arms and chest. Some people can have a raised red rash with blisters or eruptions which look like pimples. Those people who do not become ill from the valley fever, they can only find out that they have been infected when they later have a positive blood or skin test or when small areas of residual infection (nodules) in the lungs show up on a routine chest X – ray. In the most cases, nodules do not cause problems but they can look like cancer on X – rays. If someone develops symptoms, especially severe ones, then the course of the disease is highly variable. It can take months to recover fully from this disease and joint aches and fatigue can last even longer. The severity of this disease is depending on many factors in which are included the number of fungus spores you inhale and the overall health.
- Chronic coccidioidomycosis: If you have initial coccidioidymocisis and if it does not resolve completely, then it can progress to a chronic form of pneumonia. It is known that this complication is most common in people who have weakened immune system. Here are some signs and symptoms:
- Nodules in the lungs
- Blood – tinged sputum (matter discharge during coughing)
- Chest pain
- Weight loss
- Low – grade fever
- Disseminated coccidioidomycosis: This is the most serious form of this disease. It is happening when the infection spreads (disseminates) beyond the lungs to the other parts of your body. In the most cases, these parts include heart, brain, liver, bones, skin and the membranes that protect the spinal cord (meninges) and brain.  The symptoms of this form are depending on which parts of your body are affected and they can include:
- Meningitis – an infection of the membranes and fluid surrounding the brain and spinal cord
- Painful, swollen joints, especially in the knees or ankles
- Painful lesions in the skull, spine or other bones
- Skin lesions, nodules and ulcers which are more serious than the rash that sometimes occurs with other forms of the disease
Valley fever distribution
Coccidioides posadasii or Coccidioides immitis is the fungi which is cause for the valley fever. It thrives in the arid desert soils of northern Mexico, California’s San Joaquin Valley, southern Arizona and Nevada. Also these fungi are endemic to Texas, New Mexico and parts of the South and Central America – in the areas who have mild winters and arid summers. [4,5]
 Centers for Disease Control and Prevention (CDC). Valley fever (coccidioidomycosis). Retrieved from www.cdc.gov/fungal/diseases/coccidioidomycosis/index.html
 National Institute of Allergy and Infectious Diseases (NIAID). Two clinical trials focus on serious fungal disease valley fever. 2018. Retrieved from www.niaid.nih.gov/news-events/two-clinical-trials-focus-serious-fungal-disease-valley-fever
 Nguyen C, Barker BM, Hoover S, et al. Recent advances in our understanding of the environmental, epidemiological, immunological, and clinical dimensions of coccidioidomycosis. Clinical Microbiology Reviews. 2013;26(3):505–25.
 Lang R, Stokes W, Lemaire J, et al. A case report of Coccidioides posadasii meningoencephalitis in an immunocompetent host. BMC Infectious Diseases. 2019.
 Laniado-Laborin R, Arathoon EG, Canteros C, et al. Coccidioidomycosis in Latin America. Medical Mycology. 2019;57:S46-S55.