Fatal disseminated coccidioidomycosis occurred in a 56-year-old black cotton mill worker who had never traveled west of the Mississippi River. The suspected source of infection was dust in cotton grown in the San Joaquin Valley of California. A survey of 46 employees in the cotton textile mill revealed no other clinical disease, but one positive skin test reaction to coccidioidin in a man without any other explanation for sensitivity suggests that occupational exposure does occur to a very limited degree.
Gehlbach SH, Hamilton JD, Conant NF. Coccidioidomycosis: An Occupational Disease in Cotton Mill Workers. Arch Intern Med. 1973;131(2):254–255. doi:10.1001/archinte.1973.00320080090012
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