Epidemiology

• C. immitis is endemic in the Southwestern United States - especially California, Arizona, Texas
• C. immitis is also endemic in Mexico, and Central and Southern America
• infection is acquired by inhalation of arthrospores
• the only person-to-person transmission has been indirect, through exposure to contaminated secretions - e.g. if infected pus drained into a dressing then the conditions may be favourable (moisture, nutritive conditions, correct temperature) for the fungus to complete its life cycle by converting from a tissue form to infectious airborne spores
• there is not requirement for isolation of patients with cocciodomycosis
• immunocompromised patients, pregnant women, infants, and non-white people are especially susceptible to C. immitis infection

Reference

1. Thompson GR et al. Global guideline for the diagnosis and management of the endemic mycoses: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology. Lancet Infect Dis. 2021 Dec;21(12):e364-74.