Coccidioidouria: Clinical Significance

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Abstract
Patients (12) had urine cultures positive for Coccidioides immitis. Ten patients showed the usual criteria for dissemination, but before urine culture 2 were believed to have only chronic pulmonary involvement. In 8 patients there was impairment of host defense mechanisms due to associated disease or immunosuppressive drug therapy. Only 2 of 11 patients tested reacted to coccidioidin skin-test antigen. Colony counts of C. immitis in the 1 voided morning urine specimens ranged from 0.03-17/ml. With prostatic involvement, colony counts in the expressed secretions ranged from 15-120/ml. The site of urinary tract coccidioidomycosis, which could be adduced in 9 patients, was the upper tract in 1, lower tract in 6, and upper and lower tracts in 2. In patients with lower tract infection, the prostate was involved in 4 and the epididymis in 2.