Ike Davis – Wrong Or Working Valley Fever Diagnosis?
Ike Davis first baseman player at New York Mets, has been recently diagnosed with valley fever during a routine physical exam. An X-ray pointed out fairly characteristic valley fever lesions in his lungs. Now fans somehow question this valley fever presumptive diagnosis (easy to understand why) due to the blood test that came back negative, despite the X-ray image. What is the truth then?
Valley fever is in fact a type of infection that is not caused by a bacterium nor a virus. The culprit behind valley fever symptoms (chest pain, fever, couching among others) is a fungus called Coccidioides immitis. The coccidioides species are commonly found in the soil of certain areas and can be transmitted to humans after raised in the air and inhaled during various activities. After being inhaled, the fungus reaches the lungs leading to valley fever infection and its symptoms (red, spotty rash, night sweats, chills, fever).
Now comes the good part. According to guidelines valley fever is not diagnosed based on any signs and symptoms which in most cases are nonspecific nor a chest X-ray (it can not easily differentiate between other lung infections and valley fever). The positive diagnosis is established after highlighting Coccidioides cysts in different tissue, blood samples or certain body secretions like sputum. Having these said, a question emerges: why didn’t we read anything in the recent news about a sputum smear test? Many of you will say that the blood test came up negative and there was no point for a sputum smear. Wrong! There is a possibility, in this case, that somehow prolongs the mystery: Does Ike Davis actually have valley fever?
Usually after a person is exposed, the body begins to produce antibodies against valley fever fungus that can be detected using a custom blood test for valley fever. But what if the immune system had no time to respond and produce antibodies (in some cases there is a delay of some period of time before the test cames positive – it is called immunological window).
In conclusion, in the absence of a smear test, and a negative blood test fo valley fever, whether the baseball player contracted valley fever or not remains unclear. At this point only further blood tests or perhaps a sputum smear can undeniable establish a diagnosis of valley fever.