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a fungal disease caused by infection with Coccidioides immitis. The fungus grows in hot, dry areas, especially in the southwestern United States, Mexico, and parts of Central and South America. Called also coccidioidosis and California disease. The disease occurs in a primary and in a secondary form. Primary coccidioidomycosis (called also valley fever and san joaquin valley fever) is due to inhalation of windborne spores and varies in severity from symptoms like those of the common cold to influenzalike symptoms. Secondary coccidioidomycosis is a virulent, chronic, progressive, granulomatous disease resulting in involvement of cutaneous and subcutaneous tissues, viscera, central nervous system, and lungs. Treatment consists primarily of rest. Antibiotics may be given to prevent secondary bacterial infection. Amphotericin B or ketoconazole may be used to reduce risk of extrapulmonary dissemination or in the hope of having a remission after dissemination occurs.