Valley fever here flies dangerously under docs' radar

2010-10-21T00:00:00Z 2010-10-26T11:39:22Z Valley fever here flies dangerously under docs' radarStephanie Innes Arizona Daily Star Arizona Daily Star
October 21, 2010 12:00 am  • 

Tucsonan Diana Wilkinson was misdiagnosed with lung cancer, and told loved ones she didn't have much time left.

Doctors thought another local resident, registered nurse Barbara Crummitt, had pneumonia, but the antibiotics she was prescribed didn't work. She got sicker and sicker until she was hospitalized.

Their experiences underscore a message the Pima County Medical Society is trying to get out:

Southern Arizonans who have had fatigue, cough, fever, and chest pain for longer than two weeks should not only see a doctor, but ask to be tested for valley fever.

The potentially fatal fungal infection is often underdiagnosed, resulting in hospital stays and medical expenses that could have been avoided.

The county Medical Society is launching an awareness campaign to encourage doctors to do a valley-fever test on patients with "community-acquired" pneumonia, meaning pneumonia patients who have not been recently hospitalized or in another health-care facility.

"One-third of pneumonia cases in our area are valley fever. But if you are being treated for pneumonia and aren't getting better, that kind of delay in treatment can really slow someone down," society executive director Steve Nash said.

October through December is considered a higher-risk season for valley fever, a time when reported cases typically spike. So far this year, the Arizona Department of Health Services says there have been 7,917 reported cases in the state.

But those numbers likely represent only a fraction of people who have valley fever, says Dr. John Galgiani, director of the University of Arizona Valley Fever Center for Excellence.

"We think it's severely underreported," Galgiani said. "The state now gets 10,000 reported cases per year - it could literally be three times that much."

Arizona accounts for two-thirds of all U.S. infections of the disease, Galgiani says. The vast majority of Arizona cases are found between Phoenix and Tucson, often referred to as the valley-fever corridor.

An Arizona study completed in 2006 showed that 29 percent of local pneumonia cases tested positive for valley fever, Arizona Department of Health Services epidemiologist Clarisse Tsang said.

Valley-fever treatment in Arizona in 2007 cost $86 million in hospital charges - on average $50,000 per visit, state data show.

"It's important to diagnose because a lot of times the doctor mistakes the pneumonia for a bacterial infection and treats with antibiotics, which don't fight the fungus," Tsang said. "If it's being treated inappropriately, in some cases, it can spread to the brain and require lifelong treatment. There's also a chance of death."

About 30 Arizonans die of valley fever every year, Tsang said.

Some patients may need to be tested twice - about half the blood tests in the early stages of valley fever give a false negative.

"In my experience, I went to highly qualified doctors in Tucson and they didn't test me for valley fever," said Diana Wilkinson, who works at the U.S. Institute for Environmental Conflict Resolution at the Udall Foundation. "The experience was life-changing...."

Wilkinson's illness began with severe fatigue in September 2008. She was busy at the time and forced herself to keep going. But on one trip out of town she became so tired she couldn't finish her dinner. She coughed, was nauseated and felt the room spinning.

Back in Tucson she went to a doctor and was diagnosed with pneumonia and prescribed antibiotics, but they didn't make her better.

She went through multiple tests through November and December, and was told she had lung cancer. It wasn't until she had a lung biopsy in late December that she finally received her valley-fever diagnosis. Doctors then put her on anti-fungal medication and the illness cleared up in three months.

Others live with valley fever for years.

Barbara Crummitt has been on anti-fungal medications for valley fever for the past four years. She was hospitalized in 2006 with what doctors believed was pneumonia, and they treated her with antibiotics. Her symptoms also got worse. Surgery to clear out an infection that developed in her lung cavity finally led to her valley-fever diagnosis.

And 26-year-old Christopher Fair also continues to suffer effects from a severe form of valley fever he developed four years ago, in which the infection spreads to other parts of the body. His throat swelled, he suffered spinal damage, and he was in a nursing home for six months, said his mother, Dolores Fair.

"Initially they had no idea what he had," she said. "I'd always thought valley fever meant a little cough and a positive test. I never knew it could be anything like this."

Contact reporter Stephanie Innes at sinnes@azstarnet.com or 573-4134.

Copyright 2014 Arizona Daily Star. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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