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Coccidioidomycosis Demosthenes Pappagianis, M.D., Ph.D. University of California, Davis November 2011.

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Presentation on theme: "Coccidioidomycosis Demosthenes Pappagianis, M.D., Ph.D. University of California, Davis November 2011."— Presentation transcript:

1 Coccidioidomycosis Demosthenes Pappagianis, M.D., Ph.D. University of California, Davis November 2011

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4 New Coccidioidomycosis California Correctional Institutions (CCI) January – September 2011 (UC Davis Coccidioidomycosis Serology Lab) CCIPVSPAvenalCA State MonthMonthly cases Year total Monthly cases Year total Monthly cases Year total Monthly cases Year total Jan Feb Mar Apr May Jun Jul Aug Sep

5 Domingo Escurra - First patient with Coccidioidomycosis (1892)

6 Domingo Escurra

7 Joao Silveira Second case, recognized in California (1894)

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9 Coccidioidomycosis - California Endemic Areas Coalinga Soledad Paso Robles Avenal Calif. Men’s Colony Dye Creek Corcoran Otay Tecate

10 Archeology students - California

11 Transmission of Coccidioidomycosis Human to Human CASE SOURCE OUTCOME REFERENCE Mortician abraded skin of finger while embalming Expired patient with disseminated coccidioidomycosis Spread from finger to epitrochlear and axillary lymph nodes survived no therapy Wilson et al., 1953 House staff (3), nurses (3)Patient with disseminated coccidioidomycosis of knee; organism grew on and dispersed from plaster of Paris cast dispersing arthroconidia Survived; none disseminatedEckmann et al., 1964 NeonateMother with coccidioidomycosis of endometrium and cervix Mother survived, infant diedBernstein et al., 1981 Neonates (twins)Mother with disseminated disease, transplacental Mother died, infants died Shafai, 1978 NeonateMother with disseminated coccidioidomycosis of cervix of uterus infected amniotic fluid Human with transplanted lung Donor with pulmonary coccidioidomycosisSurvived Larwood, 1962 Tripathy et al., 2002 Human with transplanted kidney Human with transplanted liver Donor with (unknown) prior disseminated coccy Fatal Wright et al., 2003 “ Human with transplanted lung Donor with quiescent coccidioidomycosis of lungs FatalMiller et al., 2004 Infant died; mother survived 5 years Female with pelvic/ abdominal coccy Husband’s semen – artificial insemination Living

12 H. Chope 1929

13 Coccidioidal Erythema Nodosum

14 ( Pappagianis 1998) Night sweats, Anorexia

15 Coccidioidomycosis - Spectrum of Disease

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17 Woman with Chronic Coccidioidal Cavity – Right Lung

18 Mannose binding lectin?

19 Time to Dissemination

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23 Coccidioidal Basilar Meningitis H. Einstein

24 CSF compartments

25 ?

26 , (-) skin tests


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