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Infeksi Jamur pada Paru
COCCIDIOIDOMYCOSIS
COCCIDIOIDOMYCOSIS
It may occur as either an acute, benign, self-limited disease or a chronic, malignant disseminated disease involving the cutaneous, subcutaneous, visceral or osseous tissue.
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Coccidioidomycosis: Valley Fever
• Coccidioides immitis - causes coccidioidomycosis
• Distinctive morphology – blocklike arthroconidia in the free-living stage and spherules containing endospores in the lungs
• Lives in alkaline soils in semiarid, hot climates and is endemic to southwestern U.S.
• Arthrospores inhaled from dust, creates spherules and nodules in the lungs
• Amphotericin B treatment
PORTAL OF ENTRY
INHALATION
INOCULATION
(Rare)
Pulmonary Symptoms
• Anorexia
• Shortness of breath
• Weight loss
• Productive cough
• Night sweats
• Arthralgia
• Erythema multiforme
ECOLOGICAL ASSOCIATION
• Desert soil
Archeological middens
Pottery
Rodent burrows
Cotton
Construction sites
SPHERULE
ENDOSPORES
ARTHROCONIDIA
SOIL
ANIMALHUMAN
____________
CLINICAL SPECIMENS
Sputum
Pus
Gastric washings
CSF
Bronchial washings
Biopsy material
SEROLOGICAL TESTS
• Complement fixation
• Immunodiffusion
• Slide agglutination
• EIA
DRUGS OF CHOICE
• Fluconazole
(mild infection)
• Itraconazole(mild infection)
• Amphotericin B
(severe infections)