Coccidioidomycosis

Infection with a fungus of the genus COCCIDIOIDES, endemic to the SOUTHWESTERN UNITED STATES. It is sometimes called valley fever but should not be confused with RIFT VALLEY FEVER. Infection is caused by inhalation of airborne, fungal particles known as arthroconidia, a form of FUNGAL SPORES. A primary form is an acute, benign, self-limited respiratory infection. A secondary form is a virulent, severe, chronic, progressive granulomatous disease with systemic involvement. It can be detected by use of COCCIDIOIDIN.

Also Known As:

Networked: 814 relevant articles (83 outcomes, 73 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Histoplasmosis
2.	Blastomycosis
3.	Infections
4.	Cryptococcosis
5.	Aspergillosis

Experts

1.	Ampel, Neil M: 36 articles (10/2022 - 08/2002)
2.	Blair, Janis E: 31 articles (10/2022 - 11/2004)
3.	Galgiani, John N: 30 articles (10/2022 - 10/2002)
4.	Hung, Chiung-Yu: 26 articles (01/2021 - 06/2003)
5.	Cole, Garry T: 20 articles (01/2021 - 06/2003)
6.	Pappagianis, Demosthenes: 17 articles (12/2018 - 09/2002)
7.	Shubitz, Lisa F: 15 articles (10/2022 - 03/2006)
8.	Stevens, David A: 15 articles (10/2022 - 09/2007)
9.	Thompson, George R: 14 articles (12/2021 - 09/2011)
10.	Fierer, Joshua: 13 articles (02/2022 - 05/2006)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Coccidioidomycosis:

1.	Fluconazole (Zonal)FDA LinkGeneric 02/01/1995 - "Successful therapy of coccidioidomycosis of the knee with fluconazole." 01/01/1990 - "SDZ89-485 was more slowly absorbed, reaching a peak level in blood of 14 micrograms/ml at 12 to 15 h after a dose of 50 mg/kg. We conclude that SDZ89-485 is more effective than fluconazole as treatment for experimental systemic coccidioidomycosis in mice, even though fluconazole achieves higher peak levels in blood." 03/01/1995 - "Fluconazole 200 or 400 mg/d is well tolerated and a moderately effective treatment for chronic pulmonary or nonmeningeal disseminated coccidioidomycosis. " 11/01/2022 - "Retrospective evaluation of the efficacy of fluconazole for the treatment of coccidioidomycosis in dogs: 49 cases (2015-2020)." 04/15/2014 - "The patient had positive coccidioidomycosis serologies and he was started on fluconazole with resolution of symptoms and improvement in transaminitis over the next month. "
2.	Amphotericin B (Amphotericin)FDA LinkGeneric 05/24/1958 - "Disseminated coccidioidomycosis apparently cured with amphotericin B." 10/01/1984 - "Central nervous system coccidioidomycosis: a clinicopathologic study of treatment with and without amphotericin B." 01/01/2009 - "We reported the first case of disseminated coccidioidomycosis from the UK successfully treated with amphotericin B, where skin biopsy was the initial clue for the correct diagnosis." 09/01/2007 - "The advent of amphotericin B ushered in the therapeutic era for coccidioidomycosis. " 09/01/2007 - "Amphotericin B and coccidioidomycosis."
3.	Itraconazole (Sporanox)FDA LinkGeneric 09/01/1990 - "The purpose of this study was to assess the tolerance and efficacy of itraconazole in the treatment of coccidioidomycosis. " 01/01/2010 - "Itraconazole treatment of nonmeningeal coccidioidomycosis in children: two case reports and review of the literature." 10/01/1994 - "Primary cutaneous coccidioidomycosis treated with itraconazole." 09/01/1991 - "We believe that itraconazole is an effective drug to treat coccidioidomycosis with a wide safety margin. " 09/01/1991 - "Sixteen patients with coccidioidomycosis were treated with itraconazole for one year. "
4.	VaccinesIBA 01/23/2006 - "This study elucidates the mechanisms needed to elicit successful immunity against coccidioidomycosis, and holds promise for development of an effective coccidioidal vaccine against coccidioidomycosis." 06/29/2012 - "These combined results suggest that the EP67 adjuvant enhances protective efficacy of the live vaccine by augmentation of T-cell immunity, especially through Th1- and Th17-mediated responses to Coccidioides infection." 01/01/2020 - "The GCP-rCpa1 vaccine has shown to elicit a mixed Th1 and Th17 response and confers protection against pulmonary coccidioidomycosis in mice. " 08/01/2009 - "Recurring epidemics and escalation of medical costs have helped to motivate production of a vaccine against valley fever. " 09/01/2007 - "Safety, antigenicity, and efficacy of a recombinant coccidioidomycosis vaccine in cynomolgus macaques (Macaca fascicularis)."
5.	AntigensIBA 01/01/1997 - "The recombinant antigen was also more effective in distinguishing the antibody levels in sera from patients with pulmonary coccidioidomycosis than in sera from those with disseminated disease. " 03/01/2007 - "The Histoplasma antigen test had positive results when urine samples from 11 (58%) of 19 patients who had acute or chronic coccidioidomycosis were tested. " 02/06/2023 - "These results provide information about the constitutive and coccidioidal antigen-specific stimulated immune profile in dogs with naturally acquired coccidioidomycosis." 02/06/2023 - "Evaluation of Host Constitutive and Ex Vivo Coccidioidal Antigen-Stimulated Immune Response in Dogs with Naturally Acquired Coccidioidomycosis." 11/12/2021 - "The utility of Coccidioides antigen and antibody detection in cerebrospinal fluid in the diagnosis of canine central nervous system coccidioidomycosis."
6.	Ketoconazole (Nizoral)FDA LinkGeneric 03/01/1988 - "From these studies, it is concluded that ketoconazole in doses above those currently recommended offer little or no benefit for most patients with non-meningeal forms of coccidioidomycosis." 10/01/1983 - "All completed studies of ketoconazole treatment of human coccidioidomycosis have been non-comparative in design. " 07/01/1980 - "Treatment of coccidioidomycosis with ketoconazole: clinical and laboratory studies of 18 patients." 11/01/1990 - "Of note, 3 patients developed coccidioidomycosis while receiving ketoconazole for other conditions.(ABSTRACT TRUNCATED AT 250 WORDS)" 03/01/1988 - "The effect of ketoconazole on adrenal cortical function was studied in 10 prepubertal children receiving long-term (3 to 52 months) high-dose (10 to 23 mg/kg/d) orally administered ketoconazole treatment because of systemic coccidioidomycosis. "
7.	TriazolesIBA 12/01/2018 - "Findings update serologic parameters that are relevant for clinical assessment of coccidioidomycosis patients in the triazole era." 09/01/2015 - "Oral triazole antifungals have had a great impact on the management of coccidioidomycosis. " 05/01/2010 - "The treatment of coccidioidomycosis has most recently depended on oral triazole therapy. " 09/01/2007 - "In 1996, a 12-year-old female chimpanzee was undergoing treatment with an experimental triazole, BayR3783, for coccidioidomycosis when she was diagnosed with severe conjunctivitis in the right eye. " 01/01/1994 - "The new triazole, D0870, was tested for therapeutic efficacy in the treatment of experimental systemic murine coccidioidomycosis. "
8.	AzolesIBA 10/01/2022 - "The purpose of this study is to assess the incidence of coccidioidomycosis among lung transplant recipients receiving universal lifelong azole antifungal prophylaxis. " 09/01/2023 - "Serologic Rebound after Stopping Azoles for Primary Pulmonary Coccidioidomycosis: A Case-Controlled Observational Study." 03/01/2023 - "NAC incidence and risk amongst solid organ transplant (SOT) recipients in Arizona receiving prolonged azole course for coccidioidomycosis prophylaxis have not been well elucidated. " 10/10/2022 - "The increasing Valley Fever cases in the past decades, the expansion of endemic regions, and the rising azole drug-resistant strains have underscored an urgent need for a better understanding of Coccidioides biology and new antifungal strategies. " 10/01/2022 - "Universal lifelong azole prophylaxis was associated with a low rate of coccidioidomycosis among lung transplant recipients residing in endemic regions."
9.	Antifungal AgentsIBA 09/01/2007 - "A number of studies addressing the efficacy of various antifungal agents have been performed, and the results of these studies as they pertain to skeletal coccidioidomycosis are summarized herein. " 01/01/2019 - "APX001 and other members of this new class of antifungal agents may offer great promise as effective therapies for coccidioidomycosis." 05/01/2006 - "For the Finland lecture, I will briefly discuss the development of the Mycoses Study Group, provide an overview of the currently available antifungal agents, and describe advances and lessons related to the treatment and management of cryptococcal meningitis (the most common form of fungal meningitis), 3 important endemic mycoses (namely, blastomycosis, histoplasmosis, and coccidioidomycosis), candidemia and invasive candidiasis (the most common forms of nosocomial fungal disease), and invasive aspergillosis (the most common form of invasive mould disease). " 08/01/2011 - "Although recent studies suggest that the incidence of symptomatic coccidioidomycosis during pregnancy is decreasing and that outcome has improved, management is complicated by the observations that azole antifungal agents can be teratogenic when given to some women, particularly at high doses, early in pregnancy. " 10/01/2016 - "Fluconazole is the antifungal agent typically used to treat pulmonary coccidioidomycosis. "
10.	Adrenal Cortex Hormones (Corticosteroids)IBA 01/01/2019 - "Rapid improvement was noted in both cases and raises the possibility that the addition of systemic corticosteroids may hasten recovery in patients with severe coccidioidomycosis." 01/01/2019 - "Corticosteroids in the Management of Severe Coccidioidomycosis." 01/01/2016 - "Ten patients in Group 1 versus none in Group 3 required systemic corticosteroids for coccidioidomycosis (p < 0.001). " 08/01/2013 - "A retrospective review was conducted of immunocompetent patients with acute pulmonary coccidioidomycosis who received systemic corticosteroids for relief of coccidioidal-related symptoms. " 06/28/1993 - "In such cases, corticosteroids may lead to overwhelming coccidioidomycosis. "

Therapies and Procedures

1.	Therapeutics 07/01/1980 - "This system provides an objective means of measuring improvement in a given patient; thus it is most useful in those diseases in which significant improvement rather than cure is a more realistic goal of therapy, e.g., coccidioidomycosis." 05/01/1990 - "These results indicate that SCH is an effective therapy for coccidioidomycosis and is superior to FLU in this comparison." 11/01/2004 - "Although reduction of fungal burden may provide an improved response to antifungal therapy, disseminated coccidioidomycosis is a systemic disease that requires appropriate systemic therapy." 10/01/2002 - "As the importance of coccidioidomycosis grows as a public health problem, our need for understanding of pathogenesis, immune responses, and improved antifungal therapy also increases in proportion. " 08/15/2015 - "Serological studies revealed increasingly positive titers for coccidioidomycosis and symptoms resolved promptly following initiation of systemic antifungal therapy. "
2.	Salvage Therapy 06/01/2013 - "Additional in vitro and in vivo evaluations are warranted to support the role of V/C salvage therapy for refractory coccidioidomycosis." 12/15/2007 - "Limited clinical experience suggests efficacy for the treatment of infections due to Zygomycetes and as salvage therapy for patients with invasive aspergillosis and coccidioidomycosis. " 08/01/2008 - "In addition, it has been licensed for use in oropharyngeal candidiasis and for salvage therapy in invasive aspergillosis, fusariosis, coccidioidomycosis, chromoblastomycosis, and mycetoma. " 06/15/2005 - "We report the outcomes of 6 patients with coccidioidomycosis who were treated with posaconazole salvage therapy after treatment with conventional antifungal therapies failed to produce sustained clinical improvement. " 04/01/2009 - "In a retrospective review of 24 patients with histoplasmosis, blastomycosis, or coccidioidomycosis treated with voriconazole (most for salvage therapy), the outcome was favorable (improved or stable) for 22 (95.8%) within 2 months of starting voriconazole and for 20 (83.3%) at the last follow-up. "
3.	Liver Transplantation 01/01/2017 - "This first observation of donor-transmitted coccidioidomycosis in a pediatric liver-transplant recipient underlines a rare condition in transplanted patients in a nonendemic area. " 01/01/2017 - "Donor-Related Coccidioidomycosis Transmitted Through Left-Liver Transplant to a Child Recipient in a Nonendemic Area." 07/01/2015 - "Disseminated cutaneous coccidioidomycosis in a liver transplant patient." 03/01/2015 - "Recipients of liver transplantation (LT) are at increased risk for symptomatic coccidioidomycosis, primarily because of chronic immunosuppression and impaired cellular immunity. " 03/01/2015 - "Universal fungal prophylaxis and risk of coccidioidomycosis in liver transplant recipients living in an endemic area."
4.	Immunotherapy 10/01/2019 - "Systematic investigation of immunotherapy for coccidioidomycosis is advisable and may help to address the recent marked increase in reports of the disease in endemic areas." 09/01/1974 - "Immunotherapy of coccidioidomycosis." 04/01/1974 - "Immunotherapy in recurrent coccidioidomycosis." 09/01/2011 - "Two cases illustrating successful adjunctive interferon-γ immunotherapy in refractory disseminated coccidioidomycosis."
5.	Chemoprevention 06/01/2019 - "Efficacy of Low Dose Chemoprophylaxis for Coccidioidomycosis Infection in Liver Transplant Recipients."