I am very closely acquainted with a person who was found to have this infection by culture of a biopsy sample during the 1980s. The person I know has never been to the parts of the United States mentioned in this article. The examination finding that prompted the biopsy was persistent cough and general fatigue accompanied by an abnormal chest X-ray. (The chest X-ray, in turn, was follow-up to a course of preventive treatment for tuberculosis, medically indicated for a foreign person who arrived in the United States Mantoux-positive for tuberculosis, perhaps from having had the BCG tuberculosis vaccine overseas. The X-ray finding was nothing at all like the chest X-ray of someone with a tuberculosis infection, but quite unusual, prompting many other diagnostic tests, including repeated biopsies.)<p>The good news is that the patient I know recovered fully after surgery. The bad news is that the patient had to have major surgery. Moreover, we are unsure to this day what the actual diagnosis was. The surgery was curative, as the patient's complaints and disabilities all went away after it was over, but the lung infection was never definitively diagnosed. (Another infectious agent was cultured after a different biopsy.) Slow-growing lung infections are very hard to diagnose. Fortunately, most people have a lot of spare lung tissue, so even removal of a whole lobe on one lung does not impair future aerobic exercise.<p>Developing better diagnostic procedures for this illness will not be easy at all, but seems well worth doing. Antifungal drugs are very hard to develop, because fungi are very biologically similar to animals, and thus a drug that works on fungi has a high probability of being toxic to human patients if taken internally.<p><a href="http://www.mayoclinic.com/health/valley-fever/DS00695/DSECTION=treatments-and-drugs" rel="nofollow">http://www.mayoclinic.com/health/valley-fever/DS00695/DSECTI...</a>