1/11. Primary cutaneous coccidioidomycosis. Reevaluation of its potentiality based on study of three new cases.The data derived from these three young patients would indicate the need for: (1) Early recognition of the primary cutaneous skin infection as being due to Coccidioides immitis. (2) The prompt use of suppressive intravenous amphotericin B therapy until such time as local tissue resistance and systemic immunity become manifest and sufficient to contain the pathogenic fungus within the initial cutaneous site of infection as manifested by complete healing of this primary lesion and its associated lymphadenopathy. It is apparent that there is a need to reassess present concepts which have been based on insufficient data, and to revise conclusions derived from the study of the eight previously reported instances of primary cutaneous coccidioidomycosis. The traumatic cutaneous inoculation of C immitis into a previously uninfected person, contrary to earlier impressions, can result not only in prolonged illness but in serious dissemination of the disease, and in one reported instance has resulted in coccidioidal meningitis.- - - - - - - - - - ranking = 1keywords = immitis (Clic here for more details about this article) |
2/11. lobomycosis (keloidal blastomycosis): case reports and overview.lobomycosis is a deep fungal disease of the skin without involvement of internal organs or mucous membranes. The disease is characterized by skin nodules and plaques resembling keloid involving the earlobes, distal parts of the upper and lower extremities, and buttocks. In severe cases, large skin areas can be covered by disseminated or grouped and confluent nodules. Most cases are reported from South and central america. The fungus paracoccidioides (Glenosporella) loboi is abundant in lesions but is extremely difficult to culture. lobomycosis is resistant to chemotherapy, but in some cases it can successfully be treated by excision. Although the diagnosis is easily established by its typical clinical, histologic, and microbiological features, it is often misdiagnosed by physicians not familiar with the disease. We describe here five patients and present an overview of this rare disease.- - - - - - - - - - ranking = 24.896146352474keywords = coccidioides (Clic here for more details about this article) |
3/11. Disseminated coccidioidomycosis.We report a case of disseminated coccidioidomycosis in a 39-year-old Japanese male whose illness developed after returning from a trip to an endemic area. He showed positive coccidioidin skin reaction throughout the entire course of his illness. The primary lesion in the lung subsequently spread to the bone. While the patient was on treatment with 5-FC, he made another trip to the same endemic area. After this episode, he developed pulmonary symptoms and cutaneous nodules on his wrist. The possibility of reinfection with Coccidioides immitis is discussed. Electron microscopy of the cutaneous nodules revealed that the spherules examined maintained their structural integrity in the granulomatous lesion, suggesting the high viability of the organism. Host-parasitic interaction in coccidioidomycosis is discussed.- - - - - - - - - - ranking = 0.5keywords = immitis (Clic here for more details about this article) |
4/11. Some unusual periorbital dermatoses.Three case reports of primary periorbital dermatitis are presented. The etiology of these were molluscum contagiosum, microsporum canis, and Coccidioides immitis. In each case, the presenting complaint was unusual since the primary lesion started in the periorbital region.- - - - - - - - - - ranking = 0.5keywords = immitis (Clic here for more details about this article) |
5/11. Disseminated coccidioidomycosis: clinical, immunologic and therapeutic aspects.A patient with disseminated coccidioidomycosis initially had pulmonary and skin manifestations and survived for 14 years before dying of meningitis due to Coccidioides immitis. In addition to several courses of amphotericin b therapy the patient received injections of transfer factor derived from appropriate donors and miconazole nitrate therapy. The immunologic defence mechanisms of the patient during the course of his disease were studied and the possibility of a cell-mediated immunologic defect, potentially reversible by transfer factor, was demonstrated.- - - - - - - - - - ranking = 0.5keywords = immitis (Clic here for more details about this article) |
6/11. Induction of cellular immunity to Coccidioides immitis after sensitization with dinitrochlorobenzene.A patient had progressive disseminated coccidioidomycosis and depressed cellular immunity to Coccidioides immitis. He developed a large nasal coccidioidal lesion that was unresponsive to conventional therapy. Application of dinitrochlorobenzene (DNCB) to the nasal lesion was temporally associated with resolution of the lesion and stabilization of the systemic disease. In addition, DNCB application was followed by signs of cellular immunity to C. immitis. These included development of delayed cutaneous hypersensitivity to coccidioidin, as well as lymphokine production and lymphoproliferative responses to coccidioidin. Similar forms of DNCB immunotherapy may prove useful in other patients with fungal disease and depressed cellular immunity.- - - - - - - - - - ranking = 3keywords = immitis (Clic here for more details about this article) |
7/11. early diagnosis and prompt treatment by surgery in Jorge Lobo's disease (keloidal blastomycosis).In 1931 the Brazilian doctor Jorge Lobo examined a patient from the Amazon Basin who had nodular confluent skin lesions over the lumbosacral region and encountered a new fungus pathogenic for man paracoccidioides loboi. This classification was based on the morphological aspect of the parasite which was very similar to paracoccidioides brasiliensis the causative agent of a systemic mycosis paracoccidioidomycosis or South American blastomycosis. Other authors use the name Loboa loboi. The final determination of the name must await cultivation of the fungus.- - - - - - - - - - ranking = 49.792292704948keywords = coccidioides (Clic here for more details about this article) |
8/11. Disseminated coccidioidomycosis associated with extreme eosinophilia.Primary coccidioidomycosis is frequently accompanied by eosinophilia in the range of 5%-10% of the peripheral white blood cell count. Dissemination of Coccidioides immitis to organs such as skin, bone, joints, and CNS usually is associated with risk factors such as sex (male), race (non-Caucasian), pregnancy, and immunosuppression. We report a case of coccidioidomycosis in an otherwise healthy African-American man with 72% eosinophilia who had dissemination to the skin, and we review cases in the literature of disseminated disease associated with eosinophilia. Marked eosinophilia may be an important early clue that dissemination of coccidioidomycosis has occurred.- - - - - - - - - - ranking = 0.5keywords = immitis (Clic here for more details about this article) |
9/11. Primary cutaneous coccidioidomycosis: a review of the literature and a report of a new case.A 31-year-old woman working in the laboratory with the mycelial phase of Coccidioides immitis developed a firm, raised, erythematous lesion on the left index finger. A biopsy specimen of the lesion grew a white mold that proved to be C immitis. A sinus tract communicating with the lesion and extending into the proximal phalanx developed. The expressed pus was positive for the tissue form of C immitis by potassium hydroxide and periodic acid-Schiff stains and fluorescent-antibody techniques. The sinus tract was irrigated with an aqueous solution of amphotericin b (Fungizone). The tract closed and the lesion decreased in size. Healing was completed in ten weeks. Primary cutaneous disease must be distinguished from disseminated disease with cutaneous manifestations. In the majority of cases, primary disease heals spontaneously whereas disseminated disease usually requires systemic treatment with amphotericin b.- - - - - - - - - - ranking = 1.5keywords = immitis (Clic here for more details about this article) |
10/11. paracoccidioidomycosis: an uncommon localization in the scrotum.paracoccidioidomycosis is a systemic fungal infection caused by the thermally dimorphic fungus paracoccidioides brasiliensis. The authors present a case of a 49-year-old man who developed verrucous lesions on nasal mucosa and on genital localization (inguinal and scrotal), without signs of systemic disease. Direct mycological examination, culture on Sabouraud glucose medium, and biopsy were positive for P. brasiliensis. The interest of this case is the genital localization which is uncommon in this infection. Moreover, there are few cases described in the literature.- - - - - - - - - - ranking = 24.896146352474keywords = coccidioides (Clic here for more details about this article) |
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