Clinical case definition

An illness characterized by one or more of the following:

• Influenza-like signs and symptoms (e.g., fever, chest pain, cough, myalgia, arthralgia, and headache)
• Pneumonia or other pulmonary lesion, diagnosed by chest radiograph
• Erythema nodosum or erythema multiforme rash
• Involvement of bones, joints, or skin by dissemination
• Meningitis
• Involvement of viscera and lymph nodes

Laboratory Criteria for Diagnosis

A confirmed case must meet at least one of the following laboratory criteria for diagnosis:

• Cultural, histopathologic, or molecular evidence of presence of Coccidioides species, or
• Positive serologic test for coccidioidal antibodies in serum, cerebrospinal fluid, or other body fluids by:
  1. Detection of coccidioidal immunoglobulin M (IgM) by immunodiffusion, enzyme immunoassay (EIA), latex agglutination, or tube precipitin, or
  2. Detection of coccidioidal immunoglobulin G (IgG) by immunodiffusion, EIA, or complement fixation, or
• Coccidioidal skin-test conversion from negative to positive after onset of clinical signs and symptoms

Case Classification

Confirmed: A case that meets the clinical case definition and is laboratory confirmed.

References:

1. Pappagianis D, Zimmer BL. Serology of coccidioidomycosis. Clin Microbiol Rev 1990 Jul;3(3):247-68.
2. Chiller TM, Galgiani JN, Stevens DA. Coccidioidomycosis. Infect Dis Clin North Am 2003 Mar;17(1):41-57, viii.
3. Valdivia L, Nix D, Wright M, et al. Coccidioidomycosis as a common cause of community acquired pneumonia. Emerg Infect Dis 2006 Jun;12(6):958-62.
4. Saubolle MA. Laboratory Aspects in the Diagnosis of Coccidioidomycosis. Ann N Y Acad Sci 2007 Mar 15.

See also:

• 1996 Case Definition
• 1995 Case Definition