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28 NORTH CAROLINA MfiDICAL JOURNAL January, 1945 A. ■r »tm A Fig. 4. Roentgenograms of the chest in case 2, continued. The first film (a) shows cavity formation in the area of consolidation; the second (b) demonstrates fluid level in the cavities. tomatic except for very rare hemoptysis. The cavities can persist for months and even years, but are benign in nature. They do not act as reservoirs for dissemination of the fungus through the body. Progressive form In approximately .05 to 0.1 per cent of infections the fungus is disseminated through the body, resulting in the progressive or granulomatous form of the disease. This occurs within a few weeks or months after the initial infection. The disseminated type produces abscesses of the subcutaneous and deeper tissues, and bony, meningeal and visceral lesions. This chronic form may rarely occur after direct introduction of the fungus through skin abrasions and puncture wounds. In the progressive form of coccidioidomycosis the symptoms depend on the site of the granulomatous infection. The most common locations are the meninges, bones, and subcutaneous tissues. In rare instances a miliary form occurs in which the disease disseminates to all parts of the body. Diagnosis Laboratory confirmation is necessary for a positive diagnosis of coccidioidomycosis. In the chronic, granulomatous form the fungus is easily demonstrated in material obtained from the local lesion. In the primary infection, it is found with difficulty in the sputum by direct examination or by culture on Sabouraud's medium. Frequently animal inoculation may be necessary to demonstrate the spherules. When the organism cannot be isolated, a presumptive diagnosis can be made by the coccidioidin skin test. This is an intracutaneous test using 1:1,000 or 1:100 dilutions of a saline coccidioidin extract. This test is analogous to the tuberculin test and has the same interpretation and limitations. The positive test is recorded, like the tuberculin test, as 1, 2, 3, or 4 plus. Regardless of the size of the reaction, it may indicate either an old or an active infection. A change from a negative to a positive reaction with repeated tests is of diagnostic significance. Precipitin and complement fixation tests have proved useful but have not been employed extensively because of difficulty in securing the antigen.
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 28 (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-17-006-0038 |
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_0038.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 | 28 |
Health Discipline | Medicine |
Full Text | 28 NORTH CAROLINA MfiDICAL JOURNAL January, 1945 A. ■r »tm A Fig. 4. Roentgenograms of the chest in case 2, continued. The first film (a) shows cavity formation in the area of consolidation; the second (b) demonstrates fluid level in the cavities. tomatic except for very rare hemoptysis. The cavities can persist for months and even years, but are benign in nature. They do not act as reservoirs for dissemination of the fungus through the body. Progressive form In approximately .05 to 0.1 per cent of infections the fungus is disseminated through the body, resulting in the progressive or granulomatous form of the disease. This occurs within a few weeks or months after the initial infection. The disseminated type produces abscesses of the subcutaneous and deeper tissues, and bony, meningeal and visceral lesions. This chronic form may rarely occur after direct introduction of the fungus through skin abrasions and puncture wounds. In the progressive form of coccidioidomycosis the symptoms depend on the site of the granulomatous infection. The most common locations are the meninges, bones, and subcutaneous tissues. In rare instances a miliary form occurs in which the disease disseminates to all parts of the body. Diagnosis Laboratory confirmation is necessary for a positive diagnosis of coccidioidomycosis. In the chronic, granulomatous form the fungus is easily demonstrated in material obtained from the local lesion. In the primary infection, it is found with difficulty in the sputum by direct examination or by culture on Sabouraud's medium. Frequently animal inoculation may be necessary to demonstrate the spherules. When the organism cannot be isolated, a presumptive diagnosis can be made by the coccidioidin skin test. This is an intracutaneous test using 1:1,000 or 1:100 dilutions of a saline coccidioidin extract. This test is analogous to the tuberculin test and has the same interpretation and limitations. The positive test is recorded, like the tuberculin test, as 1, 2, 3, or 4 plus. Regardless of the size of the reaction, it may indicate either an old or an active infection. A change from a negative to a positive reaction with repeated tests is of diagnostic significance. Precipitin and complement fixation tests have proved useful but have not been employed extensively because of difficulty in securing the antigen. |
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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