DEVELOPMENT OF SPECIFIC IMMUNITY IN PATIENTS WITH PULMONARY OR EXTRAPULMONARY BLASTOMYCOSIS

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Abstract
Lymphocyte stimulation to a fungal antigen before and during antifungal therapy was examined in 16 patients with blastomycosis. Patients with pulmonary infection did not have increased 3H-thymidine uptake on initial testing; all 8 had vigorous lymphocyte stimulation as an indicator of cellular immunity after at least 2 wk of therapy. Patients with extrapulmonary blastomycosis had higher counts in response to the Blastomyces antigen before therapy. These tests differentiated between those with blastomycosis after therapy was started and normal persons or those with a nonfungal infection. Because of the delayed appearance, lymphocyte stimulation does not appear helpful for diagnosis of persons with untreated pulmonary blastomycosis; in vitro correlates of cellular immunity developed in these patients in a similar time course as with other chronic infections.