PRIMARY CUTANEOUS COCCIDIOIDOMYCOSIS IN AGRICULTURAL WORKERS.
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Biomedical subjects
Publications and source records attributed to N E LEVAN.
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Cortisone administered orally, in low dosages for brief periods, promptly suppressed the allergic manifestations accompanying primary pulmonary coccidioidomycosis in 19 cases. There was no interference with the coccidioidin skin test reaction or with the usual serologic pattern. Dissemination of the disease as a sequel to the administration of cortisone and/or corticotropin has not been reported. A survey of physicians and of the known instances of disseminated coccidioidomycosis in Kern County failed to reveal any such episode. In none of the cases in which the authors gave cortisone in the presence of coccidioidomycosis was there any complication or undesirable sequel-specifically, no subsequent dissemination of the disease. The data presented are not to be interpreted as a therapeutic recommendation, but as a contribution to the information available concerning the effects of these drugs in infectious diseases.
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Infections with coccidioides immitis have been frequently associated with circumstances suggesting the likelihood of occupational origin. Some cases have been accepted as compensable by insurance carriers, the Industrial Accident Commission, and the courts. The factors considered in determining whether or not infection is of occupational origin are reviewed under the following headings.1. Laboratory infections.2. Other infections due to exposure to contaminated articles, arising outside endemic areas.3. Infections in employees entering endemic areas pursuant to their occupations.4. Primary cutaneous inoculation.5. Localization and/or aggravation of pre-existing coccidioidomycosis by occupational injury.6. Infections in agricultural workers imported into endemic areas.7. Infections in residents of endemic areas alleged to result from occupational exposures.