Coccidiomycosis
Coccidiomycosis is a chronic infection that affects in most cases the human respiratory system. The patient’s bones and skin may also be involved in the pathological process. The causative agent of the disease is fungi of the genus Coccidioides imitis, which live in the soil, but not everywhere. These fungi are characterized by a certain habitat: arid regions of the USA, Central America, Africa and Mexico. Cases have been recorded when the disease was registered in other areas, which is associated with the export of flax from those countries where Coccidioides imitis is common. In European countries, cases of coccidiomycosis are rare.
The content of the article:
Causes of coccidiomycosis
Symptoms of coccidiomycosis
Diagnosis of coccidiomycosis
Treatment of coccidiomycosis
Coccidiomycosis
Causes of coccidiomycosis
Coccidioides imitis fungi reproduce in the soil using spores. Mushroom spores with dust and wind can be carried through the air. Infection occurs by inhalation of fungal spores, as well as through the skin if its integrity is damaged for various reasons. Modern medicine knows a number of cases when coccidiomycosis entered the human body by absorption from the gastrointestinal tract. Before that, the patient had eaten certain foods, presumably infected with Coccidioides imitis. This disease is not transmitted from a sick person to a healthy one.
Symptoms of coccidiomycosis
Coccidiomycosis has a fairly long incubation period (from 7 to 18 days), moreover, the onset of the disease is often asymptomatic. The first signs of this disease may resemble the nature of the course of acute respiratory viral infections, other inflammatory diseases of the bronchi or lungs. The patient has a violation of the general somatic condition: fever, subfebrile temperature or hyperthermic syndrome, general weakness and fatigue, headache, etc. At a later stage, the patient begins to have a dry cough, shortness of breath and pain behind the sternum. On X-ray images, single granulomas (focal inflammations) can be detected at the onset of the disease, which in dynamics tend to merge and form extensive foci of inflammation. Coccidiomycosis can provoke pleurisy — inflammation of the pleura with the formation of exudate (fluid) in the pleural cavity.
Cutaneous manifestations of coccidiomycosis are joined 1-2 weeks after the first pulmonary symptoms. In cases where infection occurred through the patient’s skin, skin reactions may occur immediately, without prior changes on the part of the respiratory system.
Manifestations on the skin during the disease are very variable. The most common are papules, plaques or nodules similar to warts. Less often, single or multiple abscesses or cellulitis may occur on the patient’s skin. Abscesses tend to open spontaneously, after which ulcers remain. With appropriate treatment, ulcers heal with the formation of scars. Skin manifestations of the disease may be accompanied by pain in the area of the nearest joints and their swelling.
Such symptoms are a reason to consult a doctor immediately!
Diagnosis of coccidiomycosis
The causative agent of coccidiomycosis fungi Coccidioides imitis can be detected during microscopic studies. The material for research can be the sputum of the patient, pleural or articular fluid, as well as the discharge from the surface of the affected skin.
In some cases, samples are made using the drug coccidiodine. It should be borne in mind that such procedures often show a false positive result in patients who have previously had coccidiomycosis, and such reactions persist for several years after the disease.
X-ray examinations are relevant to detect pulmonary abscesses and foci of inflammation. If meningitis is suspected, the cerebrospinal fluid is examined. In some cases, a puncture of the joint or pleura of the lung is performed, followed by microscopic examination of the obtained materials.
Treatment of coccidiomycosis
The treatment of the disease consists in the systemic administration of antifungal drugs and antibiotics of certain groups (more often amphotericin B). Various drugs of fluconazole are effectively used. Primary treatment is quite long — from four to six weeks. In order to completely get rid of the disease, you may need longer therapy for several years, and in some cases — for life.
Sometimes symptomatic therapy is prescribed, depending on the form and severity of the course of the disease. Preparations for the local treatment of skin manifestations, iodine preparations, antihistamines (antiallergic), etc. are used.
With timely treatment of the patient for medical help, the prognosis of the disease is conditionally favorable. Conditions arising from the dissemination of the pathogen outside the lungs are associated with an unfavorable prognosis. They are considered life-threatening to the patient, since the central nervous system, skeletal muscles and skin are involved in the pathological process. Such conditions are more common in people with immunodeficiency of various origins.
