infections
Coccidioidomycosis
Treatment of Coccidioidomycosis
Antifungal medications Acute primary coccidioidomycosistypically goes away without treatment in otherwise healthy people, and recovery is usually complete. However, some doctors prefer to treat such people because of the small chance that the coccidioidomycosis will spread. Also, when people are treated, symptoms resolve more quickly. Treatment is usually with an antifungal medication, such asfluconazole. Progressive coccidioidomycosisis usually fatal unless it is treated, particularly if the immune system is weakened. About 70% of people with severe HIV infection or AIDS die within 1 month after being diagnosed. For mild to moderate progressive coccidioidomycosis,fluconazoleoritraconazoleis given by mouth. Alternatively, the doctor may treat the infection withvoriconazole, given by mouth or by vein (intravenously), orposaconazole, given by mouth. For severe progressive coccidioidomycosis,amphotericin Bis given intravenously. Doctors do not give certain antifungal medications to pregnant people in the first trimester of pregnancy because they may cause birth defects. People with mild to moderate coccidioidomycosis who are in the first trimester typically do not require treatment. However, doctors may giveamphotericin Bto pregnant people who are in the first trimester and who have a severe coccidioidomycosis infection or an infection that has spread beyond their lungs. After the first trimester, doctors may give a different antifungal medication. Pregnant people who become infected in the second or third trimester or within 6 weeks of giving birth are at risk of having the infection progress. If these people are not treated with medications, doctors follow up with them and do blood tests to determine whether the infection spreads. If meningitis develops,fluconazoleis given. People who have had meningitis due to coccidioidomycosis must takefluconazolefor the rest of their life because relapses are common and potentially fatal. People with a weakened immune system must take medications for years, often for life. If bone is infected or if the infection results in spaces in the lung, surgery may be necessary. 