Coccidioidomycosis

Coccidioidomycosis is a disease of the Western hemisphere caused by dimorphic soil-dwelling fungi of the genus Coccidioides. First recognized as a clinical entity in Argentina in 1882, the first case associated with the San Joaquin Valley in California was reported soon after [1]. Early cases presented with inflammatory lesions of the skin, bones, and joints that progressed to death despite attempts at treatment. By the turn of the century, the causative organism was identified as a mould despite its resemblance in tissue to a protozoan [2]. For the first 40 years after its initial description, coccidioidomycosis was thought to be a relatively rare but disfiguring and usually fatal disease. However, more benign cases of pulmonary disease associated with erythema nodosum or erythema multiforme were linked with coccidioidal infection during the 1930s [3]. This form of illness, called Valley Fever, led to speculation that not all cases of coccidioidomycosis were fatal and that there was a wide spectrum of clinical manifestations after infection [4].