BEDSIDE INTERHUMAN TRANSMISSION OF COCCIDIOIDOMYCOSIS VIA GROWTH ON GOMITES - EPIDEMIC INVOLVING 6 PERSONS

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Abstract
Interhuman transmission of coccidioidomycosis, although theoretically possible by direct or indirect means, heretofore has not been definitely demonstrated. A newly described and highly hazardous form of indirect interhuman transmission via growth on a bedside fomite is presented. Incubation of the fungus in a plaster cast applied to a draining coccidioidal osteomyelitis resulted in mild to severe primary coccidioidomycosis in 6 hospital personnel. Recovery of the organism was made and the sequence of events duplicated in the laboratory, including growth of Coccidioides immitis on a plaster cast and subsequent infection of exposed mice. Because of the potential hazard involved with draining coccidioidal lesions, the following precautions now appear indicated in their management: plaster casts should be avoided when possible, in favor of other, more hygienic forms of immobilization; when casts are unavoidable, wide, uncovered areas should be left over wounds and drainage sites; dressings must be changed frequently, and dressings and surrounding areas should be disinfected frequently with a fungicidal disinfectant; bedside fomites and linens should be changes or cleaned frequently; hospital personnel should be given coccidioidin skin tests periodically to detect unobserved infection.

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