3
Diagnosis
Î Urban areas within endemic regions of Arizona have demonstrated
that coccidioidal infection accounted for 24% of newly diagnosed CAP
in ambulatory patients.
Î The most common initial syndrome is that of a respiratory illness with
signs and symptoms typical of pneumonia — fever, drenching night
sweats, and weight loss. Often the most striking systemic symptom is
that of extreme fatigue.
Î The usual incubation period for early coccidioidal syndromes is from
1–4 weeks.
Î In some patients with early coccidioidal infection, dermatologic or
rheumatologic complaints may dominate their illness. Both erythema
nodosum and erythema multiforme occur in coccidioidomycosis.
Î Rheumatologic complaints are typically arthralgias of multiple joints,
generally symmetrical, more of the distal lower extremities, and
almost never associated with detectable joint effusions.
Figure 2. Areas Endemic for Coccidioidomycosis
Image courtesy of www.cdc.gov
