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Coccidioidomycosis — or valley fever — is caused by a fungus found in soil and is endemic in the southwestern U.S., Mexico, and Central and South America. In endemic areas of the U.S., reported cases increased eightfold between 1998 and 2012. Incidence has also increased in nonendemic areas (NEJM JW Infect Dis May 27 2014; [e-pub] and MMWR Morb Mortal Wkly Rep 2014; 63:450).
Retrospective analysis of data from the Missouri Department of Health and Senior Services revealed that 93 confirmed coccidioidomycosis cases were reported in the state between 2004 and 2013, with incidence per 100,000 increasing from 0.05 to 0.28 during that period. The median age of the patients was 58, and the median time to diagnosis in those with a known symptom-ons…