VALLEY FEVER (San Joaquin Valley Fever; Coccidioidomycosis; "Cocci")
DESCRIPTIONValley fever is an infection caused by a fungus whose spores are found in soil. Valley fever is not contagious from person to person. The upper respiratory tract (including the nose, throat, sinuses, and trachea) and the lymph glands are involved. Appropriate health care includes: self-care after diagnosis; physician's monitoring of general condition and medications; hospitalization (severe cases only).
SIGNS & SYMPTOMS
The infection is usually so mild that it produces no symptoms. In a few cases your child's symptoms may be quite severe. They include cough; sore throat; chills and fever; headache; muscle aches; shortness of breath; skin rash; general ill feeling; depression; sweating at night; weight loss; stiff neck (sometimes).
Infection by the fungus, coccidioides immitis, which thrives in soil -- especially soil that lines rodent burrows. Susceptible persons become infected when they breathe the dust from such soil and the fungi lodge in the lungs. Incubation is 1 to 4 weeks after exposure.
RISK FACTORSGeographic location. The disease is most common in California's San Joaquin Valley, scattered regions in southern and central Arizona, and southwest Texas.
Occupational or environmental exposure to dust, such as from construction or archeological sites.
Illness that has lowered your child's resistance, especially uremia, diabetes mellitus, chronic lung disease, tuberculosis, Hodgkin's disease, leukemia, or severe burns.
PREVENTING COMPLICATIONS OR RECURRENCECannot be prevented at present.
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory skin tests and blood studies.
If your family has moved from an area where the disease is common, ask your doctor about the valley fever skin test.
POSSIBLE COMPLICATIONSSpread of infection throughout the child's body and severe illness, especially in the brain or membranes that cover the brain.
PROBABLE OUTCOMESpontaneous recovery in 3 to 6 weeks. Most children continue to feel ill for 3 to 6 weeks after signs of infection disappear.
Anti-fungal drugs are reserved for persons with severe, widespread infection, in which case they are life-saving.
Use a cool-mist humidifier, without medicine added, to increase moisture and help relieve your child's cough and sore throat.
Keep a daily weight chart for the child.
MEDICATIONMedicine is usually not necessary. For severe infection, hospitalization may be necessary for treatment with intravenous anti-fungal drugs, such as amphotericin B or ketoconazole. Both drugs are potent and have potential severe adverse reactions.
See Medications section for information regarding medicines your doctor may prescribe.
Your child should stay as active as strength allows, resting often.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?When signs of infection have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of valley fever.
The following occurs during treatment:
-- Continued weight loss.
-- Fever of 101F (38.3C) orally.
-- Diarrhea that cannot be controlled.
-- Stiff neck with severe headache.