Coccidioidomycosis natural history

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Vidit Bhargava, M.B.B.S [2]

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Coccidioidomycosis is usually a self-limited mild clinical illness. A large proportion of individuals are clinically infected without any manifestations and are thus completely asymptomatic. The remaining develop a mild pulmonary illness which in most cases is self-limited requiring no treatment, and even those cases which do require treatment have an excellent prognosis. The mortality rate is currently <0.07%. If left untreated in patients with weakened immune systems, the infection spreads throughout the body. The clinical picture may be complicated due to widespread dissemination of the organism leading to a number of complications pleural effusion, relapse, pyopneumothorax, hemoptysis, and pleuritic chest pain, synovitis and osteomyelitis.

Natural History


Complications of coccidioidomycosis include:[2][3]


The prognosis of Coccidioidomycosis is good in immunocompetent patients. It is self-limited in most of the patients and recovery is without any complications. The mortality rate is currently <0.07%. Approximately less than 1 % of patients develop disseminated coccidioidomycosis.

Factors associated with poor prognosis:


  1. Galgiani J. N. Coccidioidomycosis. In: Cecil, Russell L., Lee Goldman, and D. A. Ausiello. Cecil Medicine. Philadelphia: Saunders Elsevier, 2007.
  2. Angelo, KM.; Nnedu, ON. "Rare manifestations of coccidioidomycosis". J La State Med Soc. 165 (3): 137–9. PMID 24015425.
  3. Remesar, MC.; Blejer, JL.; Negroni, R.; Nejamkis, MR. "Experimental coccidioidomycosis in the immunosuppressed rat". Rev Inst Med Trop Sao Paulo. 34 (4): 303–7. PMID 1342086.
  4. Bergstrom L, Yocum DE, Ampel NM, Villanueva I, Lisse J, Gluck O, Tesser J, Posever J, Miller M, Araujo J, Kageyama DM, Berry M, Karl L, Yung CM (2004). "Increased risk of coccidioidomycosis in patients treated with tumor necrosis factor alpha antagonists". Arthritis Rheum. 50 (6): 1959–66. doi:10.1002/art.20454. PMID 15188373.

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