Coccidioidin Skin Reactivity in Pulmonary Coccidioidomycosis

We examined the records of 27 patients who had confirmed pulmonary coccidioidomycosis to substantiate the number of patients with negative skin tests; it was also our purpose to closely examine those patients with negative skin tests to explain why they were immunologically different. Eleven of 27 patients, (40 percent) with pulmonary coccidioidomycosis were negative to coccidioidin at the time the diagnosis was originally established. Sixteen of the 27 patients were retested with coccidioidin and 14 (88 percent) developed positive skin reactions while only two (12 percent) remained negative. Most of the patients with negative skin tests at the time of original evaluation (75 percent) had positive skin tests on rechallenge. Since the patients with negative skin tests were clinically and immunologically similar to the patients with positive skin tests, we suspect that many of the original negative reactions would have been positive had the skin testing program been more vigorously pursued.