Lec15_Coccidiodomycosis_and_vCJD

Lec15_Coccidiodomycosis_and_vCJD - Coccidiodomycosis...

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Coccidiodomycosis
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Coccidiodomycosis Coccidioidomycosis is a deep mycosis caused by the fungus Coccidioides immitis (California) /posadasii (Arizona), that generally begins as a respiratory infection. It is also known as: Cocci Valley Fever San Joaquin fever Desert rheumatism
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Coccidiodomycosis Coccidioides sp is a dimorphic fungal pathogen that exists in 2 phases: the mycelial phase , which is a mold in the soil growing in branching, septate hyphae; and the spherule phase . The mycelial phase is extremely hardy and can remain viable in the dry desert soil for months to years. After a rain, it multiplies rapidly, forming arthroconidia.
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Coccidiodomycosis Within the lung, the arthroconidia transform into new, multinucleated spherical structures called spherules . The spherules then grow larger and contain hundreds to thousands of endospores . The spherules eventually break open, releasing the endospores, which grow to form new spherules, and the cycle continues.
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Coccidiodomycosis Source: “Coccidioidomycosis: A Reemerging Infectious Disease” Emerging Infectious Diseases , Vol. 2, No. 3
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Coccidiodomycosis Source: Kevin O. Leslie, MD, Division of Anatomic Pathology, Mayo Clinic, Scottsdale, AZ.
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Coccidiodomycosis Acute Illness The primary infection is often asymptomatic. In those who develop symptoms, disease usually resembles an acute influenzal illness. Fever Headache Sore throat Chills Cough Pleuritic chest pain
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Coccidiodomycosis Acute Illness Although most cases of acute pneumonia resolve spontaneously or with treatment, a small percentage of cases cause persistent illness that lasts longer than 3 months causing chronic progressive pneumonia. Patients with chronic progressive pneumonia have persistent coughing, sputum production, hemoptysis, and weight loss. Serologic testing is almost always positive for Coccidioides sp.
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Coccidiodomycosis Acute Illness Primary infection may: Heal completely without any residual effects Leave fibrosis Leave a persistent thin-walled cavity Progress to the disseminated form of the disease
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Coccidiodomycosis Disseminated Disseminated coccidioidomycosis is a progressive, frequently fatal granulomatous disease. Disease is characterized by lung lesions and abscesses throughout the body especially in: Subcutaneous tissue Skin Bone Central Nervous System
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Coccidiodomycosis Disseminated Source: Josh Fierer, M.D., UCSD Department of Pathology
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Coccidiodomycosis Disseminated Source: John Rippon, Ph.D. University of Chicago
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Coccidiodomycosis Diagnosis The diagnosis of coccidioidal infection can be made in 3 ways: Identification of coccidioidal spherules in a cytology or biopsy specimen Culture from any body fluid that is positive for Coccidioides sp A serologic test that is positive for the organism The finding of spherules in tissue, sputum, bronchoalveolar lavage fluid, or other body fluid or
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  • Fall '10
  • A
  • Bovine spongiform encephalopathy, Prion, Transmissible spongiform encephalopathy, vCJD, Creutzfeld Jacob disease, variant Creutzfeld Jacob

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