Fungal infection caused by Coccidioides immitis and C. posadasii

Caused by inhalation of fungal arthrospores; attack rate is about 40% of exposed people

Incubation period is about 2wks

Sx vary but may include: Fever, myalgia, arthralgia, cough, chest pain, dermatlologic involvement (including erythema nodosum or erythema multiforme, or a generalized pruritic rash with red-violet placques and urticarial or edematous papules)

After meningitis caused by Coccidioides spp., pts usually maintained on oral Azoles

In a trial of discontinuation of such drugs in 18 pts who had been on them 8 to 101 months and were asymptomatic, 14 pts had relapses within 0.5 to 30 months; 3 pts died. No apparent distinguishing characteristics among 4 who didn't relapse. No control group.