June 1968

Coccidioides as an Opportunist

Author Affiliations

El Paso, Tex

From the Department of Medicine, William Beaumont General Hospital, El Paso, Tex. Doctor Roberts is now at Kirk Army Hospital, Aberdeen Proving Ground, Md; Dr. Knepshield is now at the University of Louisville Medical School, Louisville; and Dr. Wells is currently in Saigon, South Vietnam.

Arch Intern Med. 1968;121(6):568-570. doi:10.1001/archinte.1968.03640060082016

The fungus Coccidioides immitis ultimately infects most lifelong residents of highly endemic regions.1,2 Progressive primary infection occurs in probably less than 0.2% of infected individuals,3 is more frequent among persons with dark skin, and often is associated with a rising complement fixation titer and loss of prior sensitivity to intradermal coccidioidin.4-7 Considering the large number of people infected with this fungus, reports of disseminated coccidioidomycosis associated with corticosteroid therapy are infrequent. In contrast to other fungi, including Candida, Aspergillus, Mucor, and Cryptococcus, Coccidioides is not generally considered an opportunistic organism.2,8-11 This report concerns a patient with disseminated coccidioidomycosis complicating primary biliary cirrhosis. The opportunistic potential of C immitis is discussed with consideration of the pertinent literature.

Patient Summary  A 56-year-old white woman was admitted to William Beaumont General Hospital Aug 30, 1965, for management of severe hepatic cirrhosis. She was well until 17 years of age

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