What are the symptoms of Coccidioidomycosis (Valley Fever)?

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Last updated: March 30, 2025 • View editorial policy

From the Guidelines

Valley fever symptoms can range from mild to severe and often mimic those of the flu, typically appearing one to three weeks after exposure and may include fever, fatigue, cough, chest pain, headache, night sweats, muscle aches, joint pain, and a rash on the upper body or legs, as noted in the most recent guideline 1. The symptoms of valley fever, caused by the fungus Coccidioides, can vary widely in severity. Many people infected with the fungus experience no symptoms at all. For those who do develop symptoms, they may include:

  • Fever
  • Fatigue
  • Cough
  • Chest pain
  • Headache
  • Night sweats
  • Muscle aches
  • Joint pain
  • A rash on the upper body or legs Some patients may develop a painful red rash called erythema nodosum. In more severe cases, the infection can spread beyond the lungs to other parts of the body, causing symptoms specific to the affected areas, such as skin lesions, bone or joint pain, or meningitis with headaches and neck stiffness, as described in 2 and 3. The most recent guideline recommends treatment with fluconazole or itraconazole for patients with underlying immunosuppression, substantial cardiopulmonary comorbidities, or those with prolonged infection or CF titres of 1/32 or higher 1. Valley fever is contracted by breathing in fungal spores from soil in endemic regions, primarily the southwestern United States. The body's immune response to the fungus causes the symptoms, and while most people recover without treatment, those with severe symptoms or who are at high risk may need antifungal medications like fluconazole for weeks to months, as noted in 4 and 1. If you develop these symptoms after being in an endemic area, seek medical attention for proper diagnosis through blood tests or other methods.

From the Research

Symptoms of Valley Fever

The symptoms of valley fever, also known as coccidioidomycosis, can vary depending on the severity of the infection.

  • Asymptomatic infection is possible in up to two-thirds of infected persons 5
  • Symptomatic coccidioidomycosis can present with pulmonary symptoms, as pulmonary coccidioidomycosis is the most common form of symptomatic infection 5
  • Individuals with suppressed cellular immunity, such as those with HIV infection, those on immunosuppressive medications, and those who have received a solid organ transplant, are at increased risk for symptomatic coccidioidomycosis 6
  • Pregnant women and African-American men have also been identified as groups at increased risk for symptomatic and severe infection 6
  • Coccidioidal meningitis is a potentially life-threatening complication of coccidioidomycosis, affecting between 200 to 300 persons annually within the endemic area of the United States 7
  • Osteomyelitis, or infection of the bones, is another possible complication of coccidioidomycosis, and can be difficult to treat 8

Risk Factors

  • Suppressed cellular immunity, such as in individuals with HIV infection, those on immunosuppressive medications, and those who have received a solid organ transplant 6
  • Pregnancy 6, 5
  • African-American men 6
  • Comorbid conditions, such as those requiring tumor necrosis factor-α inhibitors 5

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.