Pathogenesis

Arthrospores enter the lung with inhaled air and develop into thick-walled spheres that mature and rupture, spilling numerous endospores. The endospores mature and repeat the process,

(a)

20 mm

20 mm

50 mm

Figure 23.24 Coccidioides immitis (a) Mold-phase hyphae fragmenting into barrel-shaped arthrospores, the infectious form of the fungus. (b) Spherical spores containing endospores, the form of the fungus found in tissues.

50 mm

Figure 23.24 Coccidioides immitis (a) Mold-phase hyphae fragmenting into barrel-shaped arthrospores, the infectious form of the fungus. (b) Spherical spores containing endospores, the form of the fungus found in tissues.

each time provoking an inflammatory response and subsequent immune response. Symptoms and tissue injury are caused mainly by the host's immune response to coccidioidal antigens. Usually, the organisms are eliminated by body defenses, but in a small percentage of individuals caseation necrosis can occur and result in a lung cavity. Rarely, organisms are carried throughout the body by the bloodstream and infect the skin, mucous membranes, brain, and other organs. This disseminated form of the disease occurs more often in people with AIDS or other immunodeficiency and is fatal without treatment. ■ caseation necrosis, p. 582

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