Multifactorial. Initially entering the lungs by inhaling desert dust containing coccidioides immitus/posada spores, the typical cocci infection manifests as a pneumonia. Dissemination occurs when the fungus gets into the blood stream and to distal body sites. In people who are immunocompromised or else have a specific genetic profile (african or filipino) that makes them more susceptible to sseminated cocci.
Coccidiomycosis. Inmunocompromised patients.
Aerosol. Everyone acquires, basically, cocci by inhaling spores of the mold into the lungs which may or may not cause any symptoms. In some people, dissemination outside the lung occurs which could be due to immune defects like aids. Additionally, certain ethnic groups such as filipinos and african-americans seem to have an increased risk of dissemination.