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Laboratory Acquired Coccidioidomycosis: An Analysis of 203 Individuals with Skin-test Conversion.

J. E. Johnson III, M.D.; F. R. Fekety Jr., M.D.; P. J. Kadull, M.D.; L. E. Cluff, M.D., F.A.C.P.; and J. E. Perry, M.D.
Ann Intern Med. 1963;58(4):736. doi:10.7326/0003-4819-58-4-736_2
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Outside the endemic area in the southwestern United States, coccidioidomycosis occurs primarily in laboratory workers, and is undoubtedly often asymptomatic and unrecognized. A unique opportunity for the study of laboratory-acquired coccidioidomycosis was afforded by the long-term observation of a group of personnel in a large laboratory in Maryland working with the microorganism. During an 18-year period from 1944 to 1962, 2,013 employees received skin tests with coccidioidin. Rigid safety precautions resulted in a minimum of recognized laboratory exposures to Coccidioides immitis. Nevertheless, 6 proven cases of coccidioidomycosis occurred. Of the 1,895 persons who were coccidioidin-negative on initial skin tests, 203


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