MYCELIAL FORMS OF COCCIDIOIDES IMMITIS IN SPUTUM AND TISSUES OF THE HUMAN HOST

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Abstract
The diphasic fungus Coccidioides immitis ordinarily exists in living tissues only in the parasitic, or spherule, form. Occasionally the saprophytic, or mycelial, form has been reported in pathologic sections of coccidioidal cavities and granulomas of the lung. The authors demonstrated the mycelial form of the fungus in the sputum of 4 patients with pulmonary cavities, a finding not previously reported. In a series of 12 cases of persistent pulmonary coccidioidal lesions (8 cavities and 4 granulomas), mycelial forms were demonstrated in the pathologic specimens of 6 (3 cavities and 3 granulomas). Mycelia are most likely to be found on the surface of the wall of a cavity or within the necrotic debris of a granuloma. Hyphae are often easily demonstrated when other methods fail by the use of the Hotchkiss-McManus stain. Despite the theoretic hazard of mycelia in the sputum, contagiousness of coccidioidomycosis has not been demonstrated.