Coccidioidomycosis: a growing global concern.

Coccidioidomycosis (CM) has been a recognized disease for about 130 years. The organisms (Coccidioides spp. fungi) inhabit desert soil in the southwestern USA, Mexico, and parts of Central and South America. Natural events such as dust storms, wildfires or outdoor activities including construction and gardening can disrupt the fungal arthroconidia, which easily become airborne and inhaled by the host. Approximately 60% of those exposed to arthroconidia are asymptomatic and do not require medical attention, but 30% show signs of pulmonary infection with symptoms ranging from a flu-like illness to pneumonia. In 5%-10% of cases serious or disseminated disease develops, which requires prompt diagnosis and management. About 1%-3% of infections disseminate to the CNS and if not appropriately treated are often fatal. There is an urgent need for improved diagnostics and treatments.