Lec15_Coccidiodomycosis_and_vCJD

Lec15_Coccidiodomycosis_and_vCJD - Coccidiodomycosis...

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Unformatted text preview: Coccidiodomycosis 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 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. 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. Coccidiodomycosis Source: Coccidioidomycosis: A Reemerging Infectious Disease Emerging Infectious Diseases , Vol. 2, No. 3 Coccidiodomycosis Source: Kevin O. Leslie, MD, Division of Anatomic Pathology, Mayo Clinic, Scottsdale, AZ. 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 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. 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 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 Coccidiodomycosis Disseminated Source: Josh Fierer, M.D., UCSD Department of Pathology Coccidiodomycosis Disseminated Source: John Rippon, Ph.D. University of Chicago 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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This note was uploaded on 12/07/2010 for the course EPI 220 taught by Professor A during the Fall '10 term at UCLA.

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Lec15_Coccidiodomycosis_and_vCJD - Coccidiodomycosis...

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