Eventually the right treatment was found—albeit with severe side effects—requiring four pills a day and medication administered directly into the brain every 16 weeks. Toxicity
Conventional amphotericin B desoxycholate (AmB: used since the 1950s as a primary agent) is known to be associated with increased drug-induced nephrotoxicity impairing kidney function. Other formulations have been developed such as lipid-soluble formulations to mitigate side-effects such as direct proximal and distal tubular cytotoxicity. These include liposomal amphotericin B, amphotericin B lipid complex such as Abelcet (brand) amphotericin B phospholipid complex also as AmBisome Intravenous, or Amphotec Intravenous (Generic; Amphotericin B Cholesteryl Sul), and amphotericin B colloidal dispersion, all shown to exhibit a decrease in nephrotoxicity. The latter was not as effective in one study as amphotericin B desoxycholate which had a 50% murine (rat and mouse) morbidity rate versus zero for the AmB colloidal dispersion.The cost of the nephrotoxic AmB deoxycholate, in 2015, for a patient of 70 kilograms (150 lb) at 1 mg/kg/day dosage, was approximately US$63.80, compared to $1318.80 for 5 mg/kg/day of the less toxic liposomal AmB. Epidemiology
Coccidioidomycosis is endemic to the western hemisphere between 40°N and 40°S. The ecological niches are characterized by hot summers and mild winters with an annual rainfall of 10–50 cm. The species are found in alkaline sandy soil, typically 10–30 cm below the surface.
The disease can disseminate throughout the dogs body, most commonly causing osteomyelitis (infection of the bone), which leads to lameness. Dissemination can cause other symptoms, depending on which organs are infected. If the fungus infects the heart or pericardium, it can cause heart failure and death.In cats, symptoms may include skin lesions, fever, and loss of appetite, with skin lesions being the most common.Other species in which Valley fever has been found include livestock such as cattle and horses; llamas; marine mammals, including sea otters; zoo animals such as monkeys and apes, kangaroos, tigers, etc. ; and wildlife native to the geographic area where the fungus is found, such as cougars, skunks, and javelinas. Additional images
In Popular Culture
Everything in Between, a 2022 Australian feature film, contains references to coccidioidomycosis. See also
Coccidioides
Coccidioides immitis
Coccidioides posadasii
Zygomycosis
Medical geology
List of cutaneous conditions
Thunderhead, a 1998 novel by Douglas Preston and Lincoln Child which uses the fungus and illness as a central plot point. References
Further reading
Twarog M, Thompson GR (2015). "Coccidioidomycosis: Recent Updates". Seminars in Respiratory and Critical Care Medicine. 36 (5): 746–755. doi:10.1055/s-0035-1562900. PMID 26398540. (Review). Stockamp NW, Thompson GR (2016). "Coccidioidomycosis". Infectious Disease Clinics of North America. 30 (1): 229–246. doi:10.1016/j.idc.2015.10.008. PMID 26739609. (Review). External links

U.S. Centers for Disease Control and Prevention page on coccidioidomycosis
Medline Plus Entry for coccidioidomycosis