Sketchy Microbiology: Coccidioides Immitis

Presidio San Joaquin — Coccidioides Immitis

(Presidio rhymes with Cocciodioides)

Map – Occurance of Coccidioides (South West USA)

Dust storm — Route of transmission is inhalation, very common after earthquakes

Butterfly — Mold in the “cold”, ENDOSPORE in the body!! Not yeast!!

Tumbleweeds — Spherules packed with endospores in the lungs instead of yeast when in the body

Red sombrero — Spherules are bigger than RBCs

How does it present clinically?

Usually Asymptomatic in most people

Soldier — kneeling (Knee pain), Cough (pneumonia), and Sweating (fever)

Cracks in the shape of the lungs — Radiographic images may be unremarkable with nothing showing or there may be some cavities (bricks facing in) and/or nodules (bricks facing out)

Pillars resemble shins — Cocci are associated with Erythema Nodosum (robust immune response)

Statue with immunocompromised cane — cracks and lesions in lungs show common sites of infection, rod in leg show that it effects the bone

Soldier with neck brace — can cause meningitis too

How can you prove recent infection?

KOH stain to prove, IgM against cocci indicates recent infection

Pine Cones — Treatment for local lung infections are -azoles

Frogs — Treatment for systemic infection; Amphotericin B