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March 17, 1945


JAMA. 1945;127(11):624-627. doi:10.1001/jama.1945.02860110004002

It is only during the past few years that a clear concept of the pathogenesis and clinical features of coccidioidomycosis has become apparent. Until 1936 to 1938, when Gifford1 and Dickson2 described "valley fever" as the primary or initial coccidioidal infection, this disease was considered only as the disseminated granulomatous form with an ultimate poor prognosis. Now, however, we know that the initial infection in many ways resembles primary tuberculosis, that complete clinical recovery occurs in most instances and that the granulomatous form is a dissemination following a breakdown of the primary stage.

Most of the recent reports have been concerned with young adults in the military, service, such as we are presenting today. However, one of the earliest reports of primary coccidioidomycosis dealt with this disease as it occurred in a group of children. In 1939 Faber, Smith and Dickson3 reported 24 cases in children under