1/5. A case of coccidioidomycosis diagnosed by exoantigen testing.A case of coccidioidomycosis is described which was caused by a pigmented fungus that failed to produce arthroconidia. Exoantigen testing showed that the isolate produced an antigen that gave a line of identity with coccidioides (C.) immitis. The formation of spherules in a guinea pig testis confirmed the identity of the isolate as C. immitis. The patient's serum was found to have antibodies that reacted in complement fixation and immunodiffusion tests to C. immitis antigens. The exoantigen test results were responsible for the diagnosis of coccidioidomycosis in this case.- - - - - - - - - - ranking = 1keywords = immitis (Clic here for more details about this article) |
2/5. Chronic progressive coccidioidal pneumonitis. Report of six cases with clinical, roentgenographic, serologic, and therapeutic features.Chronic progressive coccidioidal pneumonitis (CPCP) is an uncommon sequela of acute pulmonary coccidiodomycosis. Six recent patients with CPCP are described, most of whom were previously healthy. The clinical presentation was indolent, resulting in long diagnostic delays. Serial chest roentgenograms showed progressive pulmonary infiltration and sputum cultures were persistently positive for coccidioides immitis. serum complement fixation (CF) antibody titers were high, with five of six patients having titers greater than or equal to 1:16. No patients had evidence of extrapulmonary coccidioidal spread at time of diagnosis of CPCP, although hematogenous dissemination occurred later in one patient. Five patients received amphotericin b intravenously (greater than or equal to 30 mg/kg total), resulting in rapid clinical and mycologic cure, decline in CF titers, and roentgenographic improvement or stabilization. However, two of these five patients suffered permanent physiologic impairment. One patient refused therapy and remains clinically symptomatic, with chronic positivity of sputum cultures for C immitis and high CF titers.- - - - - - - - - - ranking = 0.66666666666667keywords = immitis (Clic here for more details about this article) |
3/5. Multiple pneumonias in a man infected with hiv.There are many pathogens responsible for pneumonia in persons infected with hiv. This case report describes a patient with pneumonias diagnosed sequentially and caused by pneumocystis carinii, mycobacterium gordonae, and coccidioides immitis. It demonstrates the importance of pursuing a definitive or additional diagnosis in hiv-related pulmonary disease when the response to empiric therapy or to treatment of an identified pathogen is suboptimal.- - - - - - - - - - ranking = 0.33333333333333keywords = immitis (Clic here for more details about this article) |
4/5. Pulmonary coccidioidomycosis in kentucky.coccidioidomycosis is a highly infectious disease caused by the dimorphic fungus, coccidioides immitis that is endemic to the arid and semiarid regions of the southwestern united states, mexico, central america, and south america. The majority of infections from C immitis are asymptomatic; however, approximately 40% of infected individuals present with symptoms ranging from a mild flu-like respiratory infection to acute pneumonia that may lead to chronic progressive pulmonary infection or occasionally disseminated disease. Due to the mobility of the population, increasing numbers of cases are being recognized outside endemic areas. We report five patients with coccidioidomycosis diagnosed at the University of kentucky Medical Center during the period from 1984 to 1993 in order to illustrate the clinical and radiographic spectrum of findings that may be encountered with the disease. In a patient with unexplained pulmonary symptoms, a history of recent travel to or immigration from an endemic area may be an early clue to the diagnosis of coccidioidomycosis.- - - - - - - - - - ranking = 0.66666666666667keywords = immitis (Clic here for more details about this article) |
5/5. Aureobasidium pneumonia in a post liver transplant recipient: a case report.This is the first report of Aureobasidium (A.) pullulans as an opportunistic pulmonary infection in a liver transplant recipient. A 46-year-old caucasian man had an orthotopic liver transplant in 1988. His liver disease was primary sclerosing cholangitis. He required 2 subsequent liver re-transplants for primary graft non-function and acute rejection. The patient had been living in the california desert for two months prior to admission and presented with ventilator-dependent acute respiratory failure and hemodialysis-dependent acute renal failure. Imaging studies revealed severe bilateral infiltrates. His initial bronchoalveolar lavage (BAL) and brushings grew A. pullulans. Pancultures, including sputum and throat cultures, were negative for bacterial or other fungal organisms. The patient responded to pulmonary support and aggressive systemic antifungal agents while being maintained on cyclosporine and prednisone for immunosuppression. He was discharged to a skilled nursing facility 37 days after hospitalisation. Delay in discharge was primarily due to severe malnutrition and renal impairment. Opportunistic fungal infections continue to be a major problem in immunosuppressed patients including liver transplant recipients. Here we report a pulmonary infection with coccidioides (C.) immitis and superinfection with A. pullulans. opportunistic infections such as A. pullulans can be treated successfully with systemic fluconazole when amphotericin b is not well tolerated.- - - - - - - - - - ranking = 0.33333333333333keywords = immitis (Clic here for more details about this article) |