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January, llJ45 COCCIDIOIDOMYCOSIS—McCRACKEN 27 Fig. 3. Roentgenograms of the chest in case 2. The second film (b) reveals an area of increased density in the left upper lobe, appearing one week after the first film (a), which is negative. Clinical Ma nifes ta tions Primary form The clinical manifestations of coccidioidomycosis are varied. Many cases are subclinical and the only evidence of infection with the fungus is a positive coccidioidin skin test. The primary infection usually produces an illness with low grade fever (99 to 101 F.), chills, anorexia, headaches, and backache. Pleural pain may be present as a mild, constricting sensation or may be severe enough to suggest coronary occlusion, cholecystitis, or renal colic. Cough is usually non-productive, but may produce small amounts of muco-purulent sputum, sometimes blood streaked. The onset of the infection may be gradual or sudden. In its initial stages the disease is usually diagnosed as influenza, atypical pneumonia, or a common cold. Physical examination reveals a healthy appearing individual. There may be a mild nasopharyngitis. The chest signs vary according to the degree of pulmonary involve- ment and may be lacking entirely or may be those of pneumonia, fibrinous pleurisy, or pleural effusion. Skin lesions suggestive of erythema nodosum have been observed in 3 to 24 per cent of the cases. These skin lesions appear during the first three weeks of the infection and are most frequently seen on the shins, knees, thighs and upper extremities. Erythema multiforme is another skin manifestation and may appear alone or in addition to the erythema nodosum. Patients with skin involvement are less likely to develop the progressive form of the disease. A transient, acute polyarthritis also may occur. Almost any joint may be involved, but the knees and ankles are the most frequent sites. Symptomatic response to salicylates is not so striking as in rheumatic fever. A roentgenogram of the chest may reveal one or more of the following changes: 1. Soft, fuzzy hilar densities. 2. Pneumonia-like infiltrations. 3. Nodular parenchymal lesions. 4. Mediastinal and hilar adenopathy. 5. Pleural effusion. The pneumonic infection may result in cavity formation, but this is usually asymp-
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-2001] |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1945 |
Identifier | NCHH-17-006 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 6 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-006.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-006 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Description
Fixed Title * | Page 27 (image) |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1945 |
Identifier | NCHH-17-006-0037 |
Form General | Periodicals |
Page Type | all; all images; x-ray; article |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | northcarolinamed61945medi_0037.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 6 |
Issue Number | 1 |
Page Number | 27 |
Health Discipline | Medicine |
Full Text | January, llJ45 COCCIDIOIDOMYCOSIS—McCRACKEN 27 Fig. 3. Roentgenograms of the chest in case 2. The second film (b) reveals an area of increased density in the left upper lobe, appearing one week after the first film (a), which is negative. Clinical Ma nifes ta tions Primary form The clinical manifestations of coccidioidomycosis are varied. Many cases are subclinical and the only evidence of infection with the fungus is a positive coccidioidin skin test. The primary infection usually produces an illness with low grade fever (99 to 101 F.), chills, anorexia, headaches, and backache. Pleural pain may be present as a mild, constricting sensation or may be severe enough to suggest coronary occlusion, cholecystitis, or renal colic. Cough is usually non-productive, but may produce small amounts of muco-purulent sputum, sometimes blood streaked. The onset of the infection may be gradual or sudden. In its initial stages the disease is usually diagnosed as influenza, atypical pneumonia, or a common cold. Physical examination reveals a healthy appearing individual. There may be a mild nasopharyngitis. The chest signs vary according to the degree of pulmonary involve- ment and may be lacking entirely or may be those of pneumonia, fibrinous pleurisy, or pleural effusion. Skin lesions suggestive of erythema nodosum have been observed in 3 to 24 per cent of the cases. These skin lesions appear during the first three weeks of the infection and are most frequently seen on the shins, knees, thighs and upper extremities. Erythema multiforme is another skin manifestation and may appear alone or in addition to the erythema nodosum. Patients with skin involvement are less likely to develop the progressive form of the disease. A transient, acute polyarthritis also may occur. Almost any joint may be involved, but the knees and ankles are the most frequent sites. Symptomatic response to salicylates is not so striking as in rheumatic fever. A roentgenogram of the chest may reveal one or more of the following changes: 1. Soft, fuzzy hilar densities. 2. Pneumonia-like infiltrations. 3. Nodular parenchymal lesions. 4. Mediastinal and hilar adenopathy. 5. Pleural effusion. The pneumonic infection may result in cavity formation, but this is usually asymp- |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-006.pdf |
Document Sort | all; nchh-17 |
Article Title | Coccidioidomycosis |
Article Author | Joseph P. Mccracken |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-006 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
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