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Coccidioidomicose

Last reviewed: 20 Aug 2025
Last updated: 27 Feb 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • assintomático
  • febre
  • tosse
  • erupção cutânea
Full details

Other diagnostic factors

  • cefaleia
  • fadiga
  • dor torácica pleurítica
  • dispneia
  • mialgia ou artralgia
  • perda de peso
  • sudorese noturna
  • calafrios
  • estertores, roncos, sibilos ou atrito
  • sopro tubário
  • hemoptise
  • piopneumotórax
  • linfadenopatia
  • estado mental ou exame neurológico anormal
Full details

Risk factors

  • imunossupressão, especialmente supressão da imunidade celular
  • ocupação envolvendo escavação ou construção
  • atividades recreativas que aumentem a probabilidade de inalação de poeira
  • extremidades etárias
  • sexo masculino
  • residente ou visitante de áreas endêmicas
  • ascendência afro-americana ou filipina
  • grupo sanguíneo B
  • gestação
  • grupos do antígeno leucocitário humano (HLA)
  • diabetes mellitus
Full details

Diagnostic investigations

1st investigations to order

  • cultura de escarro
  • sorologia do ensaio imunoenzimático para coccidioidomicose
  • sorologia de imunodifusão para coccidioidomicose
  • sorologia de fixação de complemento para coccidioidomicose
  • Hemograma completo
  • radiografia torácica
Full details

Investigations to consider

  • teste de antígeno
  • reação em cadeia da polimerase
  • biópsia pulmonar
  • punção lombar
  • velocidade de hemossedimentação
  • tomografia computadorizada (TC) do tórax
  • cintilografia óssea
  • RNM
Full details

Emerging tests

  • ensaio de fluxo lateral (LFA)

Treatment algorithm

ACUTE

pneumonia coccidioidal leve (não gestante)

pneumonia coccidioidal grave ou difusa (não gestante)

nódulo pulmonar (não gestante)

cavidade pulmonar assintomática (não gestante)

cavidade pulmonar sintomática (não gestante)

coccidioidomicose fibrocavitária crônica progressiva (não gestante)

coccidioidomicose cutânea e dos tecidos moles (não gestante)

coccidioidomicose óssea (não gestante)

meningite coccidioidal (não gestante)

gestante

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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. Abstract

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. Abstract

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].Full text

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: Coccidioidomycosis. 2021 [internet publication].Full text

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.Full text  Abstract

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.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Differentials

    • Tuberculose
    • Infecções pulmonares micobacterianas não tuberculosas
    • Pneumonia adquirida na comunidade
    More Differentials
  • Guidelines

    • Clinical testing guidance for coccidioidomycosis, histoplasmosis, and blastomycosis in patients with community-acquired pneumonia
    • CDC Yellow Book: health information for international travel - coccidioidomycosis/valley fever
    More Guidelines
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