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Symptoms
By Mayo Clinic staffValley fever is one of three forms of coccidioidomycosis. The forms include: acute (valley fever), chronic, and disseminated.
Acute coccidioidomycosis (valley fever)
The acute form is often mild, with few, if any, symptoms. When signs and symptoms do occur, they appear one to three weeks after exposure. They tend to resemble those of the flu, and can range from minor to severe:
- Fever
- Cough
- Chest pain — varying from a mild feeling of constriction to intense pressure resembling a heart attack
- Chills
- Night sweats
- Headache
- Fatigue
- Shortness of breath
- Joint aches
- Red, spotty rash
The rash that sometimes accompanies valley fever is made up of painful red bumps that may later turn brown. The rash mainly appears on your lower legs but sometimes on your chest, arms and back. Others may have a raised red rash with blisters or eruptions that look like pimples.
If you don't become ill from valley fever, you may only learn that you've been infected when you later have a positive skin or blood test. Small areas of residual infection (nodules) in the lungs that show up on a routine chest X-ray may also be found. Although the nodules typically don't cause problems, they can look like cancer on X-ray, leading to biopsies.
If you do develop symptoms, especially severe ones, the course of the disease is highly variable. It can take from six months to a year to fully recover, and fatigue and joint aches can last even longer. The severity of the disease depends on several factors, including your overall health and the number of fungus spores you inhale.
Chronic coccidioidomycosis
Appearing as many as 20 years after the initial infection, chronic pneumonia due to coccidioidomycosis is most common in people with diabetes or weakened immune systems. You're likely to have periods of worsening symptoms alternating with periods of recovery. Signs and symptoms are similar to those of tuberculosis:
- Low-grade fever
- Weight loss
- Cough
- Chest pain
- Blood-tinged sputum
- Nodules in the lungs
Disseminated coccidioidomycosis
The most serious form of the disease, disseminated coccidioidomycosis occurs when the infection spreads (disseminates) beyond the lungs to other parts of the body. Most often these parts include the skin, bones, liver, brain, heart, and the membranes that protect the brain and spinal cord (meninges).
The signs and symptoms of disseminated disease depend on which parts of your body are affected and may include:
- Nodules, ulcers and skin lesions that are more serious than the rash that sometimes occurs with other forms of the disease
- Painful lesions in the skull, spine or other bones
- Painful, swollen joints, especially in the knees or ankles
- Meningitis — an infection of the membranes and fluid surrounding the brain and spinal cord and the most deadly complication of valley fever
