Coccidioidomycosis

Question 1

Diagnosis requires one or more of the following:

Answer 1

One or more of the following:
• Influenza-like signs and symptoms (e.g., fever, chest pain, cough, myalgia [i.e., muscle pain], arthralgia [i.e.,
joint pain], and headache);
• Pneumonia or other pulmonary lesion, diagnosed by chest radiograph;
• Erythema nodosum (i.e., red bumps) or erythema multiforme rash (i.e., mild to severe self-limited rash);
• Involvement of bones, joints, or skin by dissemination;
• Meningitis; or
• Involvement of viscera (i.e., internal organs) and lymph nodes.

Question 2

Infection may be asymptomatic or may produce an acute or chronic disease. Although the disease initially resembles an
influenza-like or pneumonia-like febrile illness primarily involving the bronchopulmonary system, dissemination can
occur to multiple organ systems.

Answer 2

Coccidioidomycosis

Question 3

Laboratory Criteria for Diagnosis

Answer 3

Any of the following:
• Cultural, histopathologic, or molecular evidence of presence of Coccidioides species;
• Coccidiodal skin-test conversion from negative to positive after onset of clinical signs and symptoms; or
• Positive serologic test for coccidioidal antibodies in serum or cerebrospinal fluid, or other body fluids by any
of the following:
o Detection of coccidiodal immunoglobulin M (IgM) by immunodiffusion, enzyme immunoassay
(EIA), latex agglutination, or tube precipitin, or
o Detection of coccidiodal immunoglobulin G (IgG) by immunodiffusion, EIA, or complement fixation.