Symptoms and Complications of Valley Fever

Acute valley fever often presents with flu-like symptoms that range from minor to severe. Some of the most common symptoms are fever, tiredness, headache, and chills. Because the infection usually begins after inhaling spores, respiratory issues like shortness of breath and coughing are also typical. The course of valley fever is extremely variable and symptoms may improve or worsen depending on many factors.

People with valley fever often experience night sweats. As the body’s immune system attempts to fight off the invading infection, the body heats up. This increase in temperature, in combination with blankets or a warmer room when sleeping, often leads to excessive perspiration. While night sweats can be uncomfortable and are symptomatic of various ailments, they are not a serious issue in and of themselves.

One of the signature symptoms of valley fever is the development of red, spotty rashes on the lower legs. These rashes are the result of erythema nodosum, a condition involving inflammation of the fat cells under the skin. Rarely, erythema nodosum also affects the chest, back, and arms.

If the initial valley fever infection does not fully resolve, it can worsen into a chronic type of pneumonia. Because of this, the respiratory issues present in the acute form of the infection become more pronounced.  A sore throat, resulting from coughing and other symptoms, can make it difficult to eat, leading to weight loss. Chest pain is also common.

It is normal to cough up some mucus when combating an infection. This is sputum that forms in the lower airways. Blood-tinged sputum usually occurs when there is inflammation of the larynx, trachea, or bronchi. The lower airways may also have small tears or injuries that bleed into the sputum.

As the infection worsens, so do the symptoms. Eventually, the erythema nodosum rash may progress into large nodules and lesions. These are significantly more painful and have a fluid-filled appearance. Nodules may also develop in the lungs. Pulmonary nodules are usually asymptomatic, but their presence may help doctors diagnose the infection.

During the recovery process, nodules may become small cavities that can lead to significant complications, such as bronchopleural fistulas or hydropneumothorax. Symptoms of these cavities include worsening cough, breathing issues, sputum production, and fever. Smaller cavities may resolve on their own, while larger ones require surgical intervention.

Rarely, valley fever may move beyond the lungs, into other structures and tissues. This is the most dangerous form of valley fever and has the worst symptoms. As the infection spreads to the joints, significant swelling and pain can inhibit mobility. The knees and ankles are the most common sites of these issues, but they may affect any joint.

A valley fever infection can spread to the bones, causing osteomyelitis. People with osteomyelitis often feel pain originating from a specific bone, as well as redness, weakness, and fever. Valley fever-related osteomyelitis can spread to the spine, which then affects mobility and strength. Without treatment, osteomyelitis can lead to osteonecrosis, arthritis, and skin cancer.

Perhaps the worst symptom of valley fever occurs when the infection spreads to the fluid and membranes surrounding the brain and spinal cord. These areas, the meninges, help protect the central nervous system. When an infection spreads here, [citation href="https://www.mayoclinic.org/diseases-conditions/valley-fever/symptoms-causes/syc-20378761" title=Mayo Clinic" desc="Valley Fever"]meningitis develops and serious symptoms occur. People with meningitis develop a high fever, severe headaches, nausea, vomiting, light sensitivity, and seizures. Severe meningitis can lead to brain damage, shock, or even death.