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How is valley fever treated ?

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Practicing since : 1994
Answered : 10 Questions
Mother (69 years old, 5foot 3 inch, 145 pounds) has a very bad case of valley fever that was left untreated for 11 years. Last year, removed a nodule from the lung thinking it was cancer, but it was valley fever. Lived in AZ for 14 years, now in PA. Has been on anti-fungal for about 8 months. She has a weird wood-like substance that comes out of her nose. Any ideas?
Posted Wed, 25 Apr 2012 in Ear, Nose and Throat Problems
Answered by Dr. Dinesh Goyal 3 hours later

Thanks for your query.

Generally acute disease almost always goes away without treatment. Bedrest and treatment of flu-like symptoms until fever disappears is recommended. Whereas disseminated or severe disease should be treated with amphotericin B, ketakonazole, fluconazole, or itraconazole

How well the person does depends on the form of the disease they have and their overall health. The outcome in acute disease is likely to be good. With treatment, the outcome is usually good for chronic or severe disease (although relapses may occur). People with disseminated disease have a high death rate.

Now, there are three forms of coccidioidomycosis: acute. chronic or disseminated

Acute pulmonary coccidioidomycosis. It almost always mild, with few or no symptoms, and goes away without treatment. The incubation period -- the time between breathing in the spores and becoming sick -- is 7 to 21 days.

Chronic pulmonary coccidioidomycosis can develop 20 or more years after initial infection. Infections (lung abscess) can form and rupture, releasing pus (empyema) between the lungs and ribs (pleural space).

Disseminated coccidioidomycosis is a widespread form of the disease. Infection spreads to other parts of the body, including the skin, brain, bones, and heart. meningitis occurs in up to half of all people with disseminated coccidioidomycosis.

In your case it appears that she is suffering from disseminated form of disease and requires antifungal drugs for long period. Wood like substance which is coming out from nose looks like to be nothing but coccidomycosis. KOH preparation is entailed to confirm the diagnosis.

Hope this answers your query. Should you have any more concerns, I will be available for follow ups.

Thanks & Regards,
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