Fatigue in coccidioidomycosis. Quantification and correlation with clinical, immunological, and nutritional factors

While described in the past, the frequency and degree of fatigue associated with symptomatic coccidioidomycosis has never been quantified. Using the Fatigue Severity Scale (FSS), severe fatigue (FSS score = 41) was found in 65% of cases of active coccidioidomycosis compared to 42% in cohort of control subjects with chronic medical diseases (P = 0.024). Fatigue in patients with symptomatic coccidioidomycosis declined significantly over four months (P = 0.023). Severe fatigue in patients with symptomatic coccidioidomycosis was significantly associated with low body mass index (BMI; P = 0.024) but was not significantly associated with either serum leptin (r² = 0.078, P = 0.261) or serum TNF-α (r² = 0.028, P = 0.504) concentrations. Severe fatigue is a common condition among patients with active coccidioidomycosis and is associated with a declining BMI.