Valley Fever

In many cases, the infection doesn’t cause symptoms. But if you do have Valley fever symptoms, they may include:

• Bumpy, discolored (red, purple, brown or black) skin rash (erythema nodosum)
• Cough
• Feeling very tired (fatigue)
• Fever
• Joint pain
• Muscle pain
• Night sweats
• Shortness of breath (dyspnea)

Healthcare providers sometimes call bumps (nodules), fever and joint stiffness “desert rheumatism.”

A healthcare provider will review your medical history, ask about your symptoms and travel history, and perform a physical exam. To help confirm a Valley fever diagnosis, they may recommend tests like:

• Biopsy. A provider takes a small amount of tissue and sends it to a lab to look for signs of Coccidioides.
• Blood tests. Blood tests are the most common way to diagnose Valley fever. They’ll send a blood sample to a lab to look for signs of Coccidioides, like antibodies or antigens.
• Imaging tests. A provider may recommend a chest X-ray or CT scan to look for signs of Valley fever pneumonia.

How is Valley fever treated?

Valley fever treatment depends on how severe it is. Your healthcare provider may recommend a “watchful waiting” approach. That means you don’t need immediate treatment because you don’t have severe symptoms. But they’ll watch your condition with regular testing.

If you have a serious or ongoing infection, or if you have risk factors for severe illness (like chronic obstructive pulmonary disease or COPD), they may prescribe antifungal medications. These may include:

• Amphotericin B for infusion
• Fluconazole
• Itraconazole

You may need to take antifungal treatments for three to six months. But it may be longer if you have a severe case of Valley fever or develop complications.

When should I see my healthcare provider?

Contact a healthcare provider if you live in or travel to an area where Coccidioides is common and you’ve had flu-like symptoms for more than a week.

If a provider diagnoses you with Valley fever, contact them or go to the nearest emergency room if you experience any of the following symptoms:

• Blood in your saliva (spit)
• Stiff neck
• Trouble breathing
• Vision or hearing changes

You may wish to ask your provider the following questions during your appointment:

• Am I at a high risk for a severe Valley fever infection?
• What type of Coccidioides fungi caused my infection?
• What treatment do you recommend?
• Should I look out for any other symptoms?
• When should I go to the ER?

What can I expect if I have Valley fever?

Most people recover from Valley fever without any long-term problems. But a small number of people develop ongoing lung infections. These can take a long time to go away — sometimes several years. Valley fever is fatal in fewer than 1 out of every 100 people who have it.

In rare cases, the fungus can move to other parts of your body. Without treatment, coccidioidomycosis in your brain can be fatal.

How long does Valley fever last?

Coccidioidomycosis symptoms usually go away on their own after a few weeks or months.

A small number of people can have ongoing disease in their lungs. If it goes on for a long time, healthcare providers call it chronic (long-term) pulmonary coccidioidomycosis. Symptoms of chronic pulmonary coccidioidomycosis include:

• Chest pain
• Chronic cough
• Coughing up blood (hemoptysis)
• Shortness of breath
• Unexplained weight loss

Can you get Valley fever twice?

In most cases, if you get Valley fever and recover, you’re unlikely to get it again.

It’s challenging to avoid breathing in Coccidioides spores if you live in an area where they’re common. But you can help reduce your risk of Valley fever by:

• Avoiding areas where you may encounter dirt or dust
• Closing your windows and staying inside during dust storms
• Running high-efficiency particulate air (HEPA) filters in your home
• Wearing an N95 respirator mask during activities like gardening, digging or other yard work that can expose you to fungal spores