Dr. Andrew Racette, DO, from the Western University Health Sciences/Phoenix reported at the annual meeting of the American Academy of Dermatology that the Coccidioides species of fungus represents a serious threat.

The Coccidioides fungus is found in soil particularly at warm and dry areas with low rain fall, high summer temperatures, and low altitude. It is found in the southwest United States, as well as Mexico, and South America. (source: doctorfungus.org - http://www.doctorfungus.org/thefungi/Coccidioides.htm).

Unlike tuberculosis, which should be tested for before beginning a TNF-a Inhibitor, the infections by this particular fungus appear to be new primary infections, according to Dr. Racette.

According to a report from Rheumatology News - Click here, although more data is needed to establish guidelines for patients where Coccidioides reside, the following was suggested by Dr. Racette:

Pretreatment screening for Coccidioides infection and taking into account a person's work environment since those who work outdoors are at a greater risk.

Monitoring for infection during therapy. Symptoms most commonly found for an infection by Coccidioides are cough, fever, and fatigue, although the infection can become serious and, in some cases, life-threatening.

Deciding whether to resume TNF-a therapy after an infection because of the risk for serious reactivation.

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