A STUDY OF ONE HUNDRED CASES WITH A POSITIVE COCCIDIOIDIN SKIN TEST

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Abstract
Of 372 patients who had spent time in the s.-w. U. S., tested intracut. for coccidioidomycosis, 125 gave a positive reaction to the skin test. Of the positive reactors, 100 selected cases who showed a pulmonary lesion by X-ray during the period of observation were chosen for study. These individuals were also skin tested with tuberculin. The lung lesions of 34 of the selected patients could be classified as coccidioidomycosis. Of the 34 patients, 9 showed Coccidioides immitis in the sputum; 15 had a negative tuberculin skin test; and 10 showed C. immitis in the sputum by smear only, or lesions of coccidioidomycosis elsewhere than in the lungs. The lung lesions in the remaining 66 patients who had a positive skin test for both coccidioidin and tuberculin were evaluated in the light of the experience with the known positive cases. The evidence indicated that the lesions in 36 of these cases were due to coccidioidomycosis. A pulmonary lesion by X-ray in an individual with a positive coccidioidin in tuberculin skin test was considered most likely to be coccidioidomycosis if the lesion was nodular, round, discrete, < 3.5 cm. in diam., of a density less than Ca but greater than the usual vascular density in the hilum of the lung, and associated with suggestive or definite hilar adenopathy.