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Friday, April 1, 2011

COCCIDIOIDOMYCOSIS

This is caused by Coccidioides immitis and found in Southern United States, and Central and South America. The disease is acquired by inhalation.

Clinical features
In 40% of cases it affects the lungs, lymphnodes and skin. Rarely it may be carried by the blood stream to the bones, adrenals, meninges and other organs. In 60% of patients the infection is asymptomatic. Infections, including subclinical attacks, are followed by immunity.
Diagnosis
The fungi grow readily on culture media but as they are higly infective, diagnostic investigations are usually limited to intradermal, complement fixation and precipitin tests. Some localised pulmonary lesions can be treated by surgery.
Management
Amphotericin or ketoconazole (200-400 mg daily for 1 year) may be helpful. but relapse is common.

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