Coccidioidomycosis: The initial pulmonary infection and beyond

Coccidioidomycosis is an infection caused by the soil-inhabiting fungus Coccidioides immitis. The fungus is endemic in the desert Southwest, which is a major area of population growth and tourism. Increasing travel through this region results in exposure to C. immitis for many people each year. Thus, newly acquired coccidioidal infections can be responsible for pneumonia and other manifestations in patients when they return home to nonendemic parts of the country. Coccidioidomycosis is a fungal infection whose importance extends nationwide, and it is crucial that physicians everywhere have a heightened awareness of this infection to avert delays in diagnosis and treatment. This article describes pulmonary coccidioidomycosis and its complications for clinicians who practice outside of the endemic regions.