Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- asymptomatic
- fever
- cough
- rash
Otros factores de diagnóstico
- headache
- fatigue
- pleuritic chest pain
- dyspnea
- myalgia or arthralgia
- weight loss
- night sweats
- chills
- rales, rhonchi, wheeze, or rub
- bronchial breathing
- hemoptysis
- pyopneumothorax
- lymphadenopathy
- abnormal mental status or neurologic exam
Factores de riesgo
- immunosuppression, especially suppression of cell-mediated immunity
- occupation involving digging or construction
- recreational activities that increase likelihood of dust inhalation
- extremes of age
- male sex
- residing in or visiting endemic areas
- African-American or Filipino ancestry
- blood group B
- pregnancy
- HLA groups
- diabetes mellitus
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- sputum culture
- enzyme immunoassay serology for coccidioidomycosis
- immunodiffusion serology for coccidioidomycosis
- complement fixation serology for coccidioidomycosis
- CBC
- chest x-ray
Pruebas diagnósticas que deben considerarse
- antigen testing
- polymerase chain reaction (PCR)
- lung biopsy
- lumbar puncture
- erythrocyte sedimentation rate
- CT chest
- bone scan
- MRI
Pruebas emergentes
- lateral flow assay (LFA)
Algoritmo de tratamiento
mild to moderate coccidioidal pneumonia (nonpregnant; without HIV)
mild to moderate coccidioidal pneumonia (nonpregnant; with HIV)
severe or diffuse coccidioidal pneumonia (nonpregnant; without HIV)
severe or diffuse coccidioidal pneumonia (nonpregnant; with HIV)
pulmonary nodule (nonpregnant)
asymptomatic pulmonary cavity (nonpregnant)
symptomatic pulmonary cavity (nonpregnant)
chronic progressive fibrocavitary coccidioidomycosis (nonpregnant)
skin and soft tissue coccidioidomycosis (nonpregnant)
skeletal coccidioidomycosis (nonpregnant)
coccidioidal meningitis (nonpregnant)
pregnant
Colaboradores
Autores
Janis E. Blair, MD
Professor of Medicine
Mayo Clinic College of Medicine and Sciences
Rochester
MN
Division of Infectious Diseases
Mayo Clinic
Phoenix
AZ
Divulgaciones
JEB declares that she has no competing interests.
Revisores por pares
Susan Hoover, MD
Infectious Diseases Clinic
Sanford Health Sioux Falls
SD
Divulgaciones
SH declares that she has no competing interests.
Astrid Mayr, MD
Professor of Medicine
Department of Hygiene and Medical Microbiology
Medical University Innsbruck
Innsbruck
Austria
Divulgaciones
AM declares that she has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Thompson GR 3rd, Le T, Chindamporn A, et al. Global guideline for the diagnosis and management of the endemic mycoses: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology. Lancet Infect Dis. 2021 Dec;21(12):e364-74. Resumen
Galgiani JN, Ampel NM, Blair JE, et al. 2016 Infectious Diseases Society of America (IDSA) clinical practice guideline for the treatment of coccidioidomycosis. Clin Infect Dis. 2016 Sep 15;63(6):e112-46.Texto completo Resumen
Centers for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. Section 5: travel-associated infections and diseases - coccidioidomycosis/valley fever. May 2023 [internet publication].Texto completo
National Institutes of Health, Centers for Disease Control and Prevention, HIV Medicine Association, and Infectious Diseases Society of America. Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV. Jul 2025 [internet publication].Texto completo
Hage CA, Carmona EM, Epelbaum O, et al. Microbiological laboratory testing in the diagnosis of fungal infections in pulmonary and critical care practice. An official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 2019 Sep 1;200(5):535-50.Texto completo Resumen
Limper AH, Knox KS, Sarosi GA, et al; American Thoracic Society Fungal Working Group. An official American Thoracic Society statement: treatment of fungal infections in adult pulmonary and critical care patients. Am J Respir Crit Care Med. 2011 Jan 1;183(1):96-128.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Tuberculosis
- Nontuberculous pulmonary mycobacterial infections
- Community-acquired pneumonia
Más DiferencialesGuías de práctica clínica
- Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV
- Clinical testing guidance for coccidioidomycosis, histoplasmosis, and blastomycosis in patients with community-acquired pneumonia
Más Guías de práctica clínica
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