247 Ch 247. Coccidioidomycosis (Valley Fever)

Coccidioides immitis (California) + posadasii (Arizona + other SW) — dimorphic fungus; SW USA + Northern Mexico + Central + South America endemic; “Valley Fever” (San Joaquin Valley); spectrum from asymptomatic to disseminated severe; CNS coccidioidomycosis lifelong fluconazole / itraconazole; filipino + african american + pregnant + immunocompromise = severe dissemination risk; 2024 outbreaks in SW USA + climate change expanding range。