Throughout May, Kotsur grew more tired and weak and began to get headaches. He decided on his own to discontinue the penicillin and made an appointment at his doctor’s office.

By the time he visited Dr. John Galgiani, director of the University of Arizona’s Valley Fever Center for Excellence, on June 11, he’d missed 14 days of work, and had seen three health providers in an effort to get well.

There have been 3,343 cases of valley fever reported to the state this year, through May — nearly 1,000 more cases than in the same time period last year.

The state also recorded 48 deaths due to valley fever last year, though the data is provisional and more deaths are likely being processed, Arizona Department of Health Services spokeswoman Nicole Capone said.

“We cannot predict what will happen the rest of this year, and the reason for this increase is uncertain but may be related to environmental factors such as weather and soil conditions,” she wrote in an email.

But Galgiani said newly released data on patient-ordered lab tests through Sonora Quest Laboratories indicate that in a year when valley fever cases are already up, a possible second spike in cases could occur.