COCCIDIOIDOMYCOSIS - A REEMERGING INFECTIOUS-DISEASE

Coccidioides immitis, the primary pathogenic fungus that causes coccid ioidomycosis, is most commonly found in the deserts of the southwester n United States and Central and South America. During the early 1990s, the incidence of coccidioidomycosis in California increased dramatica lly. Even though most infections are subclinical or self-limited, the outbreak is estimated to have cost more than $66 million in direct med ical expenses and time lost from work in Kern County, California, alon e. In addition to the financial loss, this pathogen causes serious and life-threatening disseminated infections, especially among the immuno suppressed, including AIDS patients. This article discusses factors th at may be responsible for the increased incidence of coccidioidomycosi s (e.g., climatic and demographic changes and the clinical problems of coccidioidomycosis in the immunocompromised) and new approaches to th erapy and prevention.