OBSERVATIONS ON PRIMARY COCCIDIOIDOMYCOSIS

Abstract

Observations on 43 cases of primary coccidioidomycosis seen in Arizona at an Air Force Base during 1946 and 1947 are reported. The diagnosis of coccidioidomycosis was confirmed by serological studies in addition to routine skin testing with coccidioidin. The nature of the symptoms encountered, the paucity of physical findings, the elevation of the sedimentation rate, and the types of polmonary involvement seen radiologically (pneumonia-like infiltrations, hilar thickening, hilar and mediastinal adenopathy, nodular parenchymal lesions, cavitation, and pleural effusion) are described. The occurrence of dysphagia as an important diagnostic help is emphasized. The relative mildness of the disease and early symptomatic recovery is mentioned. Patients were kept inactive until the sedimentation rates were normal and chest X-rays either cleared or improved. Three of the cases developed false positive Kahn reactions. The frequent persistence for many months of small fibrous nodules at the sites of the original pulmonary lesions emphasizes the need for some familiarity with the nature of this disease by physicians both in and out of the endemic areas.