Acute (Primary) Coccidioidomycosis: Roentgen Findings in a Group “Epidemic”

An “epidemic” of acute (primary) coccidioidomycosis occurring among the fourteen members of a field trip to an endemic area recently afforded an excellent opportunity to observe the early roentgen findings in this newly recognized acute fungus infection. Coccidioidal granuloma with its high mortality rate has been recognized since 1892, when Wernicke (1) discovered the double-contoured spherules in a patient's sputum, but it was not until 1937 that Dickson (2) first described the primary disease in the literature and furnished clinical and bacteriologic proof of its existence. (“Valley fever,” “desert fever,” “San Joaquin fever,” or “the bumps” had long been familiar to San Joaquin Valley physicians.) A full description of clinical and bacteriological findings is contained in the papers of Dickson (2), Dickson and Gifford (3, 4), and Faber, Smith, and Dickson (5). ‘Valley fever” patients are ill with an acute respiratory infection for from three to six weeks and most recover without complications. A perma...