Coccidioidomycosis

Coccidioides immitis and C posadasii are pathogenic dimorphic fungi responsible for causing coccidioidomycosis in the Southwestern United States and Central and South America. Antifungal therapy is beneficial and entails careful periodic assessment with therapies ranging from none or short courses of therapy to prolonged antifungal therapy. Factors that influence the decision to treat are the duration or severity of infection, radiographic findings, anticomplementary titers, presence of underlying immunosuppression, and comorbidities. Cure for disseminated infection is infrequent with current treatment regimens. This review summarizes the management guidelines for various disease manifestations and reviews data on challenging cases with newer agents.