Prevention and Treatment

Preventive measures include avoiding dust in the endemic areas. Watering and planting vegetation aid in dust control. Medications approved for treatment of the serious cases include amphotericin B and fluconazole. They markedly improve the prognosis but must be given for long periods of time, and cause troublesome side effects. Even with treatment, disseminated disease can reactivate months or years later.

Table 23.14 describes the main features of coccid-ioidomycosis.

Spelunkers' Disease (Histoplasmosis)

Histoplasmosis, like coccidioidomycosis, is usually benign but occasionally mimics tuberculosis. Rare, serious forms of the disease suggest that AIDS or other immunodeficiency may also be present. The distribution is more widespread than that of coc-cidioidomycosis and is associated with different soil and climate.

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