Since the report by Rixford and Gilchrist1 in 1896 of a condition which was then considered to be due to protozoan infection and the later studies of Ophüls,2 which showed that the parasite is a fungus, a considerable number of cases of coccidioidal granuloma have been reported in the United States. Although occasional sporadic cases have been recognized in various parts of the country, the great majority of the cases reported have originated in California. There is a growing feeling, which was voiced by Jacobson,3 that the disease is more common and more widespread geographically than is generally supposed. The close clinical and histologic resemblance of the disease to tuberculosis and the neglect of mycologic study naturally lead to some mistaken diagnoses of tuberculosis, especially in sections of the country where coccidioidal granuloma is not known to exist.
As a rule, the disease attacks primarily the skin
SMITH LM. COCCIDIOIDAL GRANULOMA: REPORT OF A CASE ORIGINATING IN WESTERN TEXAS. Arch Derm Syphilol. 1933;28(2):175–181. doi:10.1001/archderm.1933.01460020029007
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