zoonoses and communicable diseases common to ... - PAHO/WHO

320 MYCOSESNegroni, P. Micosis cutáneas y viscerales. 5.ª ed. Buenos Aires: López; 1972.Odds, F.C., A.B. Abbott. A simple system for the presumptive identification of Candidaalbicans and differentiation of strains within the species. Sabouraudia 18:301–317, 1980.Odds, F.C., A.B. Abbott. Modification and extension of tests for differentiation of Candidaspecies and strains. Sabouraudia 21:79–81, 1983.Philpott-Howard, J.N., J.J. Wade, G.J. Mufti, et al. Randomized comparison of oral flucanozoleversus oral polyenes for the prevention of fungal infection in patients at risk of neutropenia.Multicentre Study Group. J Antimicrob Chemother 31:973–984, 1993.Soltys, M.A. Bacteria and Fungi Pathogenic to Man and Animals. London: Baillière-Tindall; 1963.Syrjanen, S., S.L. Valle, J. Antonen, et al. Oral candidal infection as a sign of HIV infectionin homosexual men. Oral Surg Oral Med Oral Pathol 65:36–40, 1988.Vázquez, J.A., V. Sánchez, C. Dmuchowski, et al. Nosocomial acquisition of Candida albicans:An epidemiologic study. J Infect Dis 168:195–201, 1993.COCCIDIOIDOMYCOSISICD-10 B38.0 acute pulmonary coccidioidomycosis; B38.1 chronic pulmonarycoccidioidomycosis; B38.3 cutaneous coccidioidomycosis; B38.7 disseminatedcoccidioidomycosis; B38.8 other forms of coccidioidomycosisSynonyms: Posada’s disease, San Joaquin Valley fever, desert fever.Etiology: Coccidioides immitis,a diphasic fungus that exists in the mycelial phasewhen it is a soil saprophyte, and in the spherule phase in organic tissues and fluids.The life cycle of C. immitis is unique among pathogenic fungi. The fungus occursin one phase in the natural environment, i.e., the soil of semiarid regions, and inanother when it is parasitic in the mammalian host. In the soil, C. immitis developsas a mycelium (a mass of filamentous hyphae that make up the fungus). The cyclebegins with the arthroconidium, or arthrospore (spore formed in the hyphae), whichin a suitable medium germinates and forms a branching, septate mycelium. Whenthe mycelium fragments, it releases into the air arthroconidia 2 to 5 microns in size.The parasitic phase begins with the inhalation of arthroconidia by man and animals.Arthroconidia grow to form thick-walled spherules 10 to 80 microns in diameter.The cytoplasm of the spherules divides to produce hundreds of endospores which,when released, disperse into the surrounding tissue and give rise to new spherules.The parasitic cycle lasts from four to six days (Drutz and Huppert, 1983) and canrevert to the saprophytic or mycelial phase if the endospores reach the soil upon thedeath of the infected animal or through bodily excretions. The endospores give riseto hyphae and renew the cycle (Stevens, 1990). However, the mycelial cycle doesnot depend on this reversion as the hyphae contain large amounts of arthroconidiathat are dispersed by the wind and colonize new sites in the soil.Geographic Distribution: Limited to the Americas. The fungus is found in aridand semiarid areas of the United States Southwest, northwestern Mexico, Argentina,