The Infectiousness of Coccidioidomycosis

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Abstract
Expts. are presented to show that it is possible to transmit coccidioidomycosis, by bronchial instillation of spherules of Coccidioides immitis, from man to animal and from animal to animal. These findings must change our view concerning the isolation of disease patients. The spherule-containing exudates were instilled into the bronchi of guinea pigs and were propelled into the smaller bronchi ramifications and alveoli by applying a minimal amt. of air pressure. 16 animals were thus injd. using exudate from a sacroiliac abscess, a psoas abscess, and an emulsion of hilus lymph nodes from a human case and from a neck abscess of a guinea pig. The animals were killed at intervals from 8 to 63 days. Infection localized to the lung occurred in every case varying from a typical primary complex of the lung, where a single lesion was seen in one lobe, and a corresp. enlarged hilus lymph node, to the involvement of all lobes simulating lobar pneumonia. Microscopically, typical granulomata contain-ing spherules in all stages of development were found in the lung and draining lymph nodes. In all cases direct NaOH mounts and/or cultures of lungs and nodes were positive for C. immitis. The lesions more closely resembled the human infections than those caused in animals by inhalation of chlamydospores. The expts. show that spherules direct from human or animal sources are infective through the respiratory tract. All active human cases of primary and secondary coccidioidomycosis should be considered contagious unless proven otherwise.

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