Diagnosis

Valley fever is difficult to diagnose solely on the basis of signs and symptoms, because they're usually vague and overlap with symptoms that occur in other illnesses. Even a chest X-ray can't distinguish valley fever from other lung diseases.

A definitive diagnosis depends on finding evidence of coccidioides organisms in tissue, blood or other body secretions. For that reason, you're likely to have one or more of the following tests:

  • Sputum smear or culture. These tests check a sample of the matter that's discharged while coughing (sputum) for the presence of coccidioides organisms.
  • Blood tests. Through a blood test, your doctor can check for antibodies against the fungus that causes valley fever.

Treatment

Rest

Most people with acute valley fever don't require treatment. Even when symptoms are severe, the best therapy for otherwise healthy adults is often bed rest and fluids — the same approach used for colds and the flu. Still, doctors carefully monitor people with valley fever.

Antifungal medications

If symptoms don't improve or become worse or if you are at increased risk of complications, your doctor may prescribe an antifungal medication, such as fluconazole. Antifungal medications are also used for people with chronic or disseminated disease.

In general, the antifungal drugs fluconazole (Diflucan) or itraconazole (Sporanox, Onmel) are used for all but the most serious forms of coccidioidomycosis disease.

All antifungals can have serious side effects. However, these side effects usually go away once the medication is stopped. Possible side effects of fluconazole and itraconazole are nausea, vomiting, abdominal pain and diarrhea.

More serious infection may be treated initially with an intravenous antifungal medication such as amphotericin B (Abelcet, Amphotec, others).

Two newer medications — voriconazole and posaconazole (Noxafil) — may also be used to treat more serious infections.

Antifungals control the fungus, but sometimes don't destroy it, and relapses may occur. For many people, a single bout of valley fever results in lifelong immunity, but the disease can be reactivated, or you can be reinfected if your immune system is significantly weakened.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Preparing for your appointment

Make an appointment with your doctor if you develop signs or symptoms of valley fever and are in or have recently returned from a region where this condition is common.

Here's some information to help you get ready and know what to expect from your doctor.

Information to gather in advance

  • Pre-appointment restrictions. At the time you make your appointment, ask if there are any restrictions you need to follow in the time leading up to your visit.
  • Symptom history. Write down any symptoms you've been experiencing, and for how long.
  • Recent exposure to possible sources of infection. Your doctor will be especially interested to know if you have recently traveled, and where.
  • Medical history. Make a list of your key medical information, including other conditions for which you're being treated and any medications, vitamins or supplements you're currently taking.
  • Questions to ask your doctor. Write down your questions in advance so that you can make the most of your time with your doctor.

The list below suggests questions to raise with your doctor about valley fever. Don't hesitate to ask more questions during your appointment.

  • What's the most likely cause of my symptoms?
  • What kinds of tests do I need?
  • What treatment approach do you recommend, if any?
  • I have these other health conditions. How can I best manage these conditions together?
  • If you're recommending medications, are there any possible side effects?
  • How long do you expect a full recovery to take, and will I need a follow-up appointment?
  • Am I at risk of any long-term complications from this condition?

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:

  • What are your symptoms?
  • When did you first begin experiencing symptoms?
  • Have your symptoms gotten worse over time?
  • Have you recently traveled? Where and when?
  • Does your work or recreational activities involve spending time in dusty outdoor environments?
  • Are you pregnant?
  • Have you been diagnosed with any other medical conditions?
  • Are you currently taking any medications, including over-the-counter and prescription drugs as well as any vitamins and supplements?
May 27, 2015
References
  1. Ferri FF. Coccidioidomycosis. In: Ferri's Clinical Advisor 2015: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2015. https://www.clinicalkey.com. Accessed April 23, 2015.
  2. Nimmer N, et al. Coccidioidomycosis. Pediatrics in Review. 2015;36:181.
  3. Nguyen C, et al. Recent advances in our understanding of the environmental, epidemiological, immunological, and clinical dimensions of coccidioidomycosis. Clinical Microbiology Reviews. 2013;26:505.
  4. Wilken JA, et al. Coccidioidomycosis Among Cast and Crew Members at an Outdoor Television Filming Event — California, 2012. MMWR. 2014;63:321.
  5. Galgiani JN, et al. Primary coccidioidal infection. http://www.uptodate.com/home. Accessed April 23, 2015.
  6. Longo DL, et al. Coccidioidomycosis. In: Harrison's Principles of Internal Medicine. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com. Accessed April 23, 2015.
  7. Coccidioidomycosis. Centers for Disease Control and Prevention. http://www.cdc.gov/fungal/diseases/coccidioidomycosis/index.html. Accessed April 23, 2015.
  8. Papadakis MA, et al., eds. Mycotic infections. In: Current Medical Diagnosis & Treatment 2014. 54th ed. New York, N.Y.: The McGraw-Hill Companies; 2015. http://www.accessmedicine.com. Accessed April 23, 2015.
  9. Coccidioidomycosis (Valley fever) — Jobs at risk. Centers for Disease Control and Prevention. http://www.cdc.gov/niosh/topics/valleyfever/risk.html. Accessed April 30, 2015.
  10. Bennett JE, et al. Coccidioidomycosis. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2010. https://www.clinicalkey.com. Accessed April 23, 2015.