Coccidioidomycosis: Epidemiology, Fungal Pathogenesis, and Therapeutic Development

  • Hazael Hernandez
  • Victor H. Erives
  • Luis R. MartinezEmail author
Tropical Mycosis (L Martinez, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Tropical Mycosis


Purpose of Review

Coccidioidomycosis can result from the inhalation of infectious spores of Coccidioides species (spp.) immitis or posadasii. Clinical manifestations range from mild flu-like disease to severe disseminated infection that can require life-long therapy. Burden of this mycosis is high in the southwest region of the USA where it is well characterized, and in many areas of Mexico and Latin America where it is inadequately characterized. Here, we provide historical data and current knowledge on Coccidioides spp. pathogenesis as well as recent progress in therapeutic and vaccine development against coccidioidomycosis.

Recent Findings

The virulence mechanisms of Coccidioides spp. are largely unknown; however, production and regulation of a spherule glycoprotein, ammonium production, and melanization have all been proposed as integral factors in Coccidioides spp.’ pathogenesis. Therapeutic options are limited and not 100% effective, but individualized treatment with triazoles or amphotericin B over the course of pulmonary or disseminated infection can be effective in resolution of coccidioidomycosis. Human immunization has not been achieved but efforts are ongoing.


Advances in therapeutic and vaccine development are imperative for the prevention and treatment of coccidioidomycosis, especially for those individuals at risk either living or traveling to or from endemic areas.


Antifungals Coccidioidomycosis Epidemiology Vaccine Valley fever Virulence 



The authors would like to thank Joshua D. Nosanchuk, M.D., for providing his review of the manuscript.

Funding Information

H. H. was supported by National Institute of General Medical Sciences (NIGMS) RISE training grant R25 GM069621-15. L.R.M. was partially supported by the National Institute of General Medical Sciences of the U.S. National Institutes of Health (NIH) under award number 1R15GM117501-01A1. L.R.M. is partially funded and has an appointment in the Infectious Diseases and Immunology cluster of the Border Biomedical Research Center (BBRC; National Institute on Minority Health and Health Disparities award number 2G12MD007592), UTEP’s Research Centers in Minority Institutions Program.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance ••Of major importance

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Hazael Hernandez
    • 1
  • Victor H. Erives
    • 1
  • Luis R. Martinez
    • 1
    Email author
  1. 1.Department of Biological Sciences, The Border Biomedical Research CenterThe University of Texas at El PasoEl PasoUSA

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