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Laboratory diagnosis of coccidioidomycosis

John N Galgiani, MD
Section Editor
Carol A Kauffman, MD
Deputy Editor
Jennifer Mitty, MD, MPH


Coccidioides spp (C. immitis and C. posadasii), fungi endemic in desert regions of the southwestern United States and Central and South America, cause coccidioidomycosis. (See "Primary coccidioidal infection", section on 'Epidemiology' and "Primary coccidioidal infection".)

Coccidioidomycosis has protean manifestations and is frequently unrecognized, especially in travelers to endemic areas who return to locations where the disease is not typically encountered. Without specific laboratory tests, it is generally not possible to differentiate coccidioidal infections from numerous other illnesses. This is especially true for the initial respiratory illness [1].

Several routine tests are commonly abnormal, especially with early coccidioidal pneumonia, but all are nonspecific. These include a slight increase in the peripheral white blood cell count, peripheral eosinophilia, and an elevated erythrocyte sedimentation rate [2]. Similarly, chest radiographs or other imaging procedures may also reveal abnormalities. Although occasionally suggestive of the precise diagnosis [3], confirmatory tests are nearly always needed. (See "Primary coccidioidal infection".)

Conventional approaches to diagnosing coccidioidomycosis involve identification or recovery of Coccidioides spp from clinical specimens and detection of specific anti-coccidioidal antibodies in serum or other body fluids.

The laboratory diagnosis of coccidioidomycosis will be reviewed here. The epidemiology, clinical manifestations, and treatment of coccidioidomycosis are discussed separately. (See "Primary coccidioidal infection" and "Coccidioidal meningitis" and "Coccidioidomycosis in compromised hosts" and "Management of pulmonary sequelae and complications of coccidioidomycosis" and "Manifestations and treatment of extrapulmonary coccidioidomycosis".)


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Literature review current through: Sep 2016. | This topic last updated: Dec 11, 2014.
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