Coccidioidomycosis pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Vidit Bhargava, M.B.B.S [2]
Pathogenesis
The pathogenesis of coccidiodomycosis can be described in following steps.
Transmission
- Coccidioiodomycosis exist as mycelia in the soil with septations.
- During hot climate or dry environment, they proliferate asexually, transforming into spores, known as arthroconidia.
- Infection is caused by inhalation of these arthroconidia. The disease is not transmitted from person to person.
Incubation period
- Incubation period of coccidioidomycosis varies from one to three weeks.
Dissemination
- Following transmission, coccidioidomycosis are deposited into terminal bronchioles and enlarge, become rounded and develop internal septations to form what are known as the spherules.
- It then disseminates to the lymphatics and blood stream to gain access to any organ of the body.
Seeding
- Spherules contain uni-nuclear cells called as endospores which may propagate the infection further as they have the capability to develop into spherules.
- This conversion of anthroconidia into spherules initiates an inflammatory reaction and leads to a chemotaxic response (peptides derived from activation of the complement pathway, leukotrienes ) which attracts neutrophils and eosinophils to the site of inflammation.
- Cell mediated immunity keeps the infection in check and keeps them limited to the organ of origin by forming granulomas.
Immune response
Coccidioidomycosis elicits cell-mediated immune responses.
- Delayed type hypersensitivity to coccidioidal antigens is common after acute infection has resolved.
- Dissemination usually occurs via the lymphatics and is more common in immune suppressed in whom the primary infection is not contained.
Associated conditions
Microscopic pathology
Microscopic Pathology
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