Last reviewed: 27 Sep 2021
Last updated: 11 Oct 2019

Summary

Definition

History and exam

Other diagnostic factors

  • 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

Risk factors

  • 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
  • immunosuppression, especially suppression of cell-mediated immunity
  • blood group B
  • pregnancy
  • HLA groups
  • diabetes mellitus

Diagnostic investigations

1st investigations to order

  • sputum culture
  • enzyme immunoassay serology for coccidioidomycosis
  • immunodiffusion serology for coccidioidomycosis
  • complement fixation serology for coccidioidomycosis
  • CBC
  • chest x-ray

Investigations to consider

  • lung biopsy
  • lumbar puncture
  • erythrocyte sedimentation rate
  • CT chest
  • bone scan
  • MRI

Treatment algorithm

Contributors

Authors

Janis E. Blair, MD

Professor of Medicine

Mayo Clinic College of Medicine and Sciences

Rochester

MN

Division of Infectious Diseases

Mayo Clinic

Phoenix

AZ

Disclosures

JEB declares that she has no competing interests.

Peer reviewers

Susan Hoover, MD

Infectious Diseases Clinic

Sanford Health Sioux Falls

SD

Disclosures

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

Disclosures

AM declares that she has no competing interests.

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