REVIEW OF MEDICAL MICROBIOLOGY

MEDICAL MYCOLOGY

1. transmitted from person to person via air-borne spherules
2. by and large an inapparent and self-limited infection in endemic areas
3. best treated with griseofulvin
4. most prevalent in the southeastern region of the United States
5. diagnosed by demonstrating arthroconidia formed in vivo

(B) Although Coccidioides immitis can cause severe and fatal infection, by far the most common form of coccidioidomycosis in the endemic area is a mild respiratory ailment, called valley fever or San Joaquin Valley fever. Virtually everyone who inhales the arthroconidia of C. immitis becomes infected and acquires a positive delayedtype hypersensitivity response. Disseminated infection occurs in only 1% of the infected individuals. Many of the patients in whom disseminated coccidioidomycosis develop have depressed cellmediated immunity. Spherules, which are pathohistologically diagnostic, are formed in the infected host but do not transmit infection to others. Griseofulvin is the drug of choice for dermatophytosis. Amphotericin B is the drug of choice for coccidioidomycosis. (Joklik et al, pp. 1092-1097; Ryan et al, pp. 607-611)

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