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Valley fever, or coccidioidomycosis, is an infection caused by Coccidioides species, a dimorphic fungal pathogen. Coccidioides species are primarily found in the arid soils of the southwestern United States and parts of Mexico, Central America, and South America, although the geographic range is expanding in response to climate change.1 Infection occurs following inhalation of Coccidioides spores. While most infected individuals will not exhibit symptoms, certain individuals, including those who are immunocompromised, are at significantly higher risk for becoming severely ill.
Confirming Valley fever typically requires a multi-pronged approach, including fungal culture, molecular testing, and serologic assessment for antibodies developed against the organism.
While the reference method for Coccidioides serologic testing includes complement fixation (CF) and immunodiffusion (ID) assays, these assays are technically challenging to perform, require manual manipulation and interpretation, and have a turnaround time to results of 48-72 hours. 2
To optimize testing, Mayo Clinic Laboratories offers an upfront, screening enzyme-linked immunosorbent assay (ELISA) to detect Coccidioides antibodies prior to testing by Coccidioides CF/ID. Samples that result as reactive by ELISA are subsequently reflexed for confirmatory, CF/ID testing. This enables:
*If reactive, will reflex to:
By the numbers
cases of Valley fever reported to the Centers for Disease Control and Prevention in 20193
of individuals with coccidioidomycosis are asymptomatic4
annual deaths associated with coccidioidomycosis3
FGEN | Fungal Culture, Routine
A new approach to diagnosing Valley fever
In this "Hot Topic," Elitza Theel, Ph.D., shares the recommended approach to serologic testing for assessment or infection with coccidioides.