[6] C. immitis is a dimorphic saprophytic fungus that grows as a mycelium in the soil and produces a spherule form in the host organism.

The spores, known as arthroconidia, are swept into the air by disruption of the soil, such as during construction, farming, low-wind or singular dust events, or an earthquake.

[13] The classic triad of coccidioidomycosis known as "desert rheumatism" includes the combination of fever, joint pains, and erythema nodosum.

Chronic fibrocavitary disease is manifested by cough (sometimes productive of mucus), fevers, night sweats and weight loss.

[15] Serious complications may occur in patients who have weakened immune systems, including severe pneumonia with respiratory failure and bronchopleural fistulas requiring resection, lung nodules, and possible disseminated form, where the infection spreads throughout the body.

[10] C. immitis is a dimorphic saprophytic fungus that grows as a mycelium in the soil and produces a spherule form in the host organism.

The spores, known as arthroconidia, are swept into the air by disruption of the soil, such as during construction, farming, low-wind or singular dust events, or an earthquake.

[19] Coccidioidomycosis diagnosis relies on a combination of an infected person's signs and symptoms, findings on radiographic imaging, and laboratory results.

[4] The fungal infection can be demonstrated by microscopic detection of diagnostic cells in body fluids, exudates, sputum and biopsy tissue by methods of Papanicolaou or Grocott's methenamine silver staining.

[citation needed] With specific nucleotide primers, C. immitis DNA can be amplified by polymerase chain reaction (PCR).

Enhancing surveillance of coccidioidomycosis is key to preparedness in the medical field in addition to improving diagnostics for early infections.

Recommended preventive measures include avoiding airborne dust or dirt, but this does not guarantee protection against infection.

[citation needed] From 1998–2011, there were 111,117 U.S. cases of coccidioidomycosis logged in the National Notifiable Diseases Surveillance System (NNDSS).

[24] Raising both surveillance and awareness of the disease while medical researchers are developing a human vaccine can positively contribute towards prevention efforts.

[25][26] Research demonstrates that patients from endemic areas who are aware of the disease are most likely to request diagnostic testing for coccidioidomycosis.

[27] Presently, Meridian Bioscience manufactures the so-called EIA test to diagnose the Valley fever, which however is known for producing a fair quantity of false positives.

Recommended prevention measures can include type-of-exposure-based respirator protection for persons engaged in agriculture, construction and others working outdoors in endemic areas.

[citation needed] On the whole, oral fluconazole and intravenous amphotericin B are used in progressive or disseminated disease, or in immunocompromised individuals.

[34] 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.

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.

In the United States, C. immitis is endemic to southern and central California with the highest presence in the San Joaquin Valley.

Approximately 25,000 cases are reported every year, although the total number of infections is estimated to be around 150,000 per year; the disease is underreported because many cases are asymptomatic, and those who do have symptoms are often difficult to distinguish from other causes of pneumonia if they are not specifically tested for valley fever.The incidence of coccidioidomycosis in the United States in 2011 (42.6 per 100,000) was almost ten times higher than the incidence reported in 1998 (5.3 per 100,000).

[49] The receiver appointed in Plata v. Schwarzenegger issued an order in May 2013 requiring relocation of vulnerable populations in those prisons.

[51] There are several populations that have a higher risk for contracting coccidioidomycosis and developing the advanced disseminated version of the disease.

Presumably this is related to highly elevated hormonal levels, which stimulate growth and maturation of spherules and subsequent release of endospores.

[56] In the U.S., Dr. E. Rixford, a physician from a San Francisco hospital, and T. C. Gilchrist, a pathologist at Johns Hopkins Medical School, became early pioneers of clinical studies of the infection.

In retrospect, Smith played a major role in both medical research and raising awareness about coccidioidomycosis,[60] especially when he became dean of the School of Public Health at the University of California at Berkeley in 1951.

[61] The strain selected for investigation was designated with the military symbol OC, and initial expectations were for its deployment as a human incapacitant.

Medical research suggested that OC might have had some lethal effects on the populace, and Coccidioides immitis started to be classified by the authorities as a threat to public health.

[citation needed] Coccidioides immitis is not on the U.S. Department of Health and Human Services'[62] or Centers for Disease Control and Prevention's[63] list of select agents and toxins.