Disseminated coccidioidomycosis: Treatment with protoanemonin

• Published in: The American journal of medicine Vol. 9; no. 3; pp. 408 - 413
• Main Authors: Conan, Neal J., Hyman, George A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.1950
• Subjects: Anti-Bacterial Agents; Coccidioidomycosis; Dermatologic Agents; Furans; Humans; Old Medline; ANTIBIOTICS; COCCIDIOIDOSIS
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/0002-9343(50)90474-8

A young white woman, while in an endemic area for C. immitis, conceived and delivered a normal baby who has remained healthy. Two months later a granulomatous but asymptomatic coccidioidal endometritis was discovered without a preceding history of respiratory infection or cutaneous lesion, at which time x-ray examination of the chest was normal. Three months later symptoms of generalized disease developed. Pulmonary lesions did not appear until nearly two years after the establishment of uterine infection. During this time repeated coccidioidin skin tests were negative, but a facial cutaneous coccidioidal granuloma appeared, followed by marked eosinophilia. Two and one-half years from its onset the disease became fulminating and terminated in death despite the use of protoanemonin which in vitro prevented the growth of the fungus isolated from the patient's blood. It is suggested that the uterus may have been the portal of entry of infection in this patient.