Thanks to Dr. Amy Wu for a great morning report on pulmonary cocci!

Learning Points:
-Primary infections due to Coccidioides sp. most frequently manifest as community-acquired pneumonia (CAP)
-Keep cocci in your differential for a patient presenting with CAP, especially if they are not clinically improving with empiric antibiotics
-There is a wide spectrum of clinical manifestations; from a subclinical, self-limited illness, to a subacute process known as Valley Fever with respiratory complaints, to disseminated (extrapulmonary) disease (most commonly spreading to bones, skin, and CNS).
-Serologies in the acute phase may be falsely negative
-Since uncomplicated primary infections are usually self-limited, the decision to treat with antifungals can be considered for patients on an individual basis.
-For more on this topic, here is a great article by the Journal of Clinical Microbiology