Coccidioidomycosis of the Larynx in Infants and Adults

1977 ◽  
Vol 86 (5) ◽  
pp. 655-660 ◽  
Author(s):  
Paul H. Ward ◽  
David Morledge ◽  
George Berci ◽  
Harmon Schwartz
Keyword(s):  
United States ◽  
Amphotericin B ◽  
Clinical Symptoms ◽  
Skin Testing ◽  
Fungal Disease ◽  
Southwestern United States ◽  
Positive Skin ◽  
Life Threatening ◽  
Primary Form

Coccidioidomycosis is a fungal disease endemic to the southwestern United States. The primary form of the disease is relatively benign and many patients, after exposure by inhalation of the sapyrophytic form of the organism, convert from negative to positive skin testing without significant clinical symptoms. The less common disseminated form represents a serious life-threatening disease and can present with granulomatous changes in the larynx. The authors' experience with disseminated coccidioidomycosis presenting in the larynx of adults and infants successfully treated with amphotericin B are presented and discussed.

Skin testing in allergy

2019 ◽  
Vol 40 (6) ◽  
pp. 366-368
Author(s):  
Gayatri Patel ◽  
Carol Saltoun
Keyword(s):  
Skin Test ◽  
Immunoglobulin E ◽  
Clinical Symptoms ◽  
Skin Testing ◽  
Smooth Muscle Contraction ◽  
Skin Tests ◽  
Test Reaction ◽  
Positive Skin ◽  
Intradermal Testing ◽  
Clinical Sensitivity

Skin tests are used in addition to a directed history and physical examination to exclude or confirm immunoglobulin E (IgE) mediated diseases, such as allergic rhinitis, asthma, and anaphylaxis, to aeroallergens, foods, insect venoms, and certain drugs. There are two types of skin testing used in clinical practice: percutaneous testing (prick or puncture) and intracutaneous testing (intradermal). Prick testing involves introducing a needle into the upper layers of the skin through a drop of allergen extract that has been placed on the skin and gently lifting the epidermis up. Various devices are available for prick testing. Intracutaneous (intradermal) testing involves injecting a small amount of allergen into the dermis. The release of preformed histamine from mast cells causes increased vascular permeability via smooth-muscle contraction and development of a wheal; inflammatory mediators initiate a neural reflex, which causes vasodilatation, which leads to erythema (the flare). Prick testing methods are the initial technique for detecting the presence of IgE. These may correlate better with clinical sensitivity and are more specific but less sensitive than intradermal testing. Sites of skin testing include the back and the volar aspect of the arm. By skin testing on the arm, the patient can witness the emergence and often sense the pruritus of the skin test reaction. Because more patients are sensitized (have IgE antibodies and positive skin test reactions) than have corresponding symptoms, the diagnosis of allergy can be made only by correlating skin testing results with the presence of clinical symptoms.

Giardia and Virus Monitoring of Sewage Effluent in the State of Arizona

1989 ◽  
Vol 21 (3) ◽  
pp. 43-47 ◽  
Author(s):  
Joan B. Rose ◽  
Ricardo De Leon ◽  
Charles P. Gerba
Keyword(s):  
United States ◽  
Produced Water ◽  
Wastewater Reuse ◽  
Limited Resource ◽  
The State ◽  
Sewage Effluent ◽  
Sand Filtration ◽  
Southwestern United States ◽  
Treatment Facilities ◽  
Giardia Cysts

Arizona, located in the arid Southwestern United States, is heavily dependent on groundwater. In order to protect this limited resource, wastewater reuse has been implemented. Virus and Giardia monitoring of wastewater used for irrigation has also been initiated as a means for controlling the public's exposure to these pathogens. Treatment facilities must produce wastewater with no detectable Giardia cysts and one virus plaque forming unit (pfu) per 40 liters (L) for unrestricted reuse. For restricted reuse, 125 pfu/40 L is allowed. Methods based on filtration were used to monitor facilities at monthly, quarterly or biannual frequencies. Results after two years of monitoring are presented. All 11 treatment facilities produced water meeting the virus standard of 125 pfu/40 L. Only plants which used sand filtration and disinfection achieved consistent levels of virus below 1 pfu/40 L. Out of 70 samples, 74% contained no detectable viruses. Giardia was detected in 29 to 50% of the samples. Most plants would need to upgrade their treatment in order to meet standards for unrestricted irrigation.

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