Dr. Donohue

Soil-fungus spores cause 'valley fever'

Dear Dr. Donohue: Do you have any information about valley fever?

-- E.B.

Valley fever has the daunting name coccidioidomycosis (kok-SID-ee-OI-doe-my-COE-suss). It's a fungal infection. The fungus thrives in the semiarid regions of the Southwestern United States and in parts of Mexico. The San Joaquin valley gave the illness the name of valley fever. It has climatic conditions perfect for growth of this soil-inhabiting fungus.

Digging in soil containing the fungus spreads fungal spores in the air. People inhale the airborne spores, and the stage is set for infection.

However, the great majority of people who inhale spores never become sick and never know they had an encounter with the valley fever fungus.

A small number of people develop a flu-like illness, never becoming very sick and quickly recovering from their rendezvous with valley fever fungus.

An even smaller number of people come down with serious infection. They have fever, muscle pains, night sweats and cough. Pneumonia is the most common manifestation of the infection, but muscles can hurt and joints can swell. The skin over the shins often sprouts a crop of painful red bumps.

The seriously ill are given antifungal drugs by vein. Neither illness nor treatment is a pleasant experience. Most, however, recover.

Dear Dr. Donohue: I am 74 years old, and for the past 20 years I have been told I have a rectocele. For years I lived with it. However, now it is causing me problems. Can you tell me what type of surgery would be best? Or can I just live with it?

Also, can you tell me what a cystocele is?

-- L.M.

Due to aging and childbirth, the supporting tissues of women's pelvic organs become slack.

They cannot support pelvic structures such as the rectum and bladder. Either or both can collapse downward and bulge into the vagina. A rectocele is a bulge of the rectum into the vagina. A cystocele is a bulge of the bladder.

Rectoceles can make it difficult to completely empty the rectum. Constipation is a common consequence.

Loss of urine control is often a consequence of a cystocele.

A woman can live with a rectocele or a cystocele if neither bothers her.

Which operation is the best? The one that the doctor feels gives the greatest relief from symptoms with the least amount of pain and time needed for recuperation.