Get the free Coccidioidomycosis Case History Form - vfce arizona

This document outlines the development and field testing of a coccidioidomycosis case history form designed to collect patient demographic and clinical information in Kern County, as well as assess

How to fill out coccidioidomycosis case history form

How to fill out Coccidioidomycosis Case History Form

1. Obtain the Coccidioidomycosis Case History Form from the appropriate health authority or medical facility.
2. Fill in the patient's personal information, including name, age, gender, and contact details.
3. Document the patient's medical history, focusing on any previous Coccidioidomycosis diagnoses or related illnesses.
4. Provide details on the patient's symptoms, including onset, duration, and severity.
5. Record any relevant exposure history, such as travel to endemic areas or contact with infected individuals.
6. List any treatments the patient has received, including medication names and dosages.
7. Complete any additional sections regarding family medical history and other health conditions.
8. Review the completed form for accuracy and sign where required before submission.

Who needs Coccidioidomycosis Case History Form?

1. Healthcare providers diagnosing or treating Coccidioidomycosis patients.
2. Public health officials tracking Coccidioidomycosis cases in the community.
3. Researchers conducting studies related to Coccidioidomycosis epidemiology.
4. Patients who have been diagnosed with or suspected to have Coccidioidomycosis for their records.

People Also Ask about

What is the life expectancy of someone with Valley fever?

Outlook / Prognosis In most cases, people with Valley fever infections recover without any long-term effects. A small number of people develop ongoing lung infections that may take several years to resolve. Less than 1% of people diagnosed with Valley fever die from it.

Where are the most cases of coccidioidomycosis occur in the US?

The affected areas of the southwestern United States include Arizona, the central valley of California, parts of New Mexico, and Texas west of El Paso. The area extends into northern Mexico, and foci occur in parts of Central America and Argentina. Coccidioides also occurs in Utah, Nevada, and southcentral Washington.

Which area of the United States has the highest incidence of coccidioidomycosis?

States usually report a total of 10,000 - 20,000 cases of Valley fever yearly in the United States. Most cases occur in California and Arizona among people over 60 years. Thousands of cases are not reported, and many are never diagnosed or misdiagnosed.

What is the history of coccidioidomycosis?

Historical background Wernicke and Posadas first described a case of coccidioidomycosis in 1892 in South America, in an Argentinean soldier with predominantly cutaneous manifestations. Two years later in the United States, a patient with disseminated coccidioidomycosis was first reported in California in 1894.

What is coccidioidomycosis in English?

The fungi's spores can be stirred into the air by anything that disrupts the soil, such as farming, construction and wind. People can then breathe the fungi into their lungs. The fungi can cause valley fever, also known as acute coccidioidomycosis (kok-sid-e-oy-doh-my-KOH-sis).

For pdfFiller’s FAQs

What is Coccidioidomycosis Case History Form?

The Coccidioidomycosis Case History Form is a standardized document used to collect information about individuals diagnosed with coccidioidomycosis, a fungal infection caused by inhaling spores from the Coccidioides fungus.

Who is required to file Coccidioidomycosis Case History Form?

Healthcare providers, physicians, and public health officials are required to file the Coccidioidomycosis Case History Form for patients diagnosed with the infection to ensure proper tracking and management of the disease.

How to fill out Coccidioidomycosis Case History Form?

The Coccidioidomycosis Case History Form should be filled out by providing accurate patient information, including demographic details, clinical history, exposure history, and laboratory results related to the diagnosis of coccidioidomycosis.

What is the purpose of Coccidioidomycosis Case History Form?

The purpose of the Coccidioidomycosis Case History Form is to facilitate the collection of standardized data for surveillance, research, and public health initiatives aimed at understanding and controlling coccidioidomycosis.

What information must be reported on Coccidioidomycosis Case History Form?

The information that must be reported on the Coccidioidomycosis Case History Form includes patient identification details, demographic data, onset and duration of symptoms, exposure history, treatment received, and laboratory findings confirming the diagnosis.