UMEM Educational Pearls

Title: Climate change and Coccidioidomycosis

Category: Infectious Disease

Keywords: Coccidioidomycosis, climate change (PubMed Search)

Posted: 5/26/2025 by Robert Flint, MD (Updated: 7/2/2025)
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Typically Coccidioidomycosis is seen in the Southwestern US. The authors of this study, using climate modeling  predict endemic areas will spread across the US to include Idaho, the Dakotas, Nebraska and Wyoming. 
Clinically, “Patients with pulmonary Coccidioides infection frequently experience fever, cough, and shortness of breath. Chest radiographic imaging may demonstrate lobar, segmental, or multifocal consolidations; cavitary lesions; and lung nodules. Given these nonspecific findings, patients with coccidioidomycosis are often treated for community-acquired pneumonia. Coccidioidomycosis should be considered in patients not improving with antibiotic treatment or in those who have exposure to or reside in endemic areas. Up to 50% of patients with pulmonary coccidioidomycosis have erythema nodosum, approximately 25% to 30% have peripheral eosinophilia, and approximately 25% have arthralgias (particularly symmetric knee and ankle arthralgia). Up to 10% of patients diagnosed with coccidioidomycosis develop disseminated disease, including skin, central nervous system, and bone and joint infection.”

References

Lee PS, Swain DL, Johnson R. Climate Change and Coccidioidomycosis. JAMA. 2025;333(11):997–998. doi:10.1001/jama.2024.27274