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September 1977, Vol 113, No. 9 >
Article | September 1977

Occupational Hazards From Deep Mycoses

Jan Schwarz, MD; Carol A. Kauffman, MD
[+] Author Affiliations

Accepted for publication Jan 31, 1977.

Reprint requests to Clinical Laboratories, Jewish Hospital, 3200 Burnet Ave, Cincinnati, OH 45229 (Dr Schwarz).


From the Clinical Laboratories, Jewish Hospital; the Division of Infectious Diseases, Department of Internal Medicine, Cincinnati Veterans Administration Hospital; and the University of Cincinnati Medical Center, Cincinnati.


Arch Dermatol. 1977;113(9):1270-1275. doi:10.1001/archderm.1977.01640090118022
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References
Comments

The increased recognition of fungi as an important cause of disease is translated into what appears as a high incidence of mycotic disease. The increase in deep mycoses associated with occupations may be due in part to better understanding of the pathogenesis of these infections.

The fact that inhalation of sporecontaining dust is the mode of infection in histoplasmosis, coccidioidomycosis, paracoccidioidomycosis, blastomycosis, and probably cryptococcosis points to any major soil digging as a potential source of such infections. Spores of Sporothrix schenckii have been found on timber, on the leaves of certain bushes, and in sphagnum moss; traumatic transcutaneous inoculation leading to sporotrichosis is well established. A connection exists between pigeons and the occurrence of cryptococcosis, and between bats and birds and histoplasmosis.

LABORATORY INFECTIONS  A special chapter in occupational disease caused by "deep fungi" is that associated with laboratory exposure; inhalation of culture material and traumatic transcutaneous inoculations have

REFERENCES

1 +
Larsh HL, Schwarz J:  Accidental inoculation blastomycosis . Cutis 19:334-337, 1977;.
2 +
Baum GL, Lerner PI:  Primary pulmonary blastomycosis: A laboratory acquired infection . Ann Intern Med 73:263-265, 1970;.
3 +
Denton J, DiSalvo AF, Hirsch ML:  Laboratory acquired North American blastomycosis . JAMA 199:935-936, 1967;.
4 +
Furcolow ML, Guntheroth WG, Willis MJ:  The frequency of laboratory infections with Histoplasma capsulatum: Their clinical and X-ray characteristics . J Lab Clin Med 40:182-187, 1952;.
5 +
Smith CE:  The hazard of acquiring mycotic infections in the laboratory . Read before the American Public Health Association Meeting, St. Louis, Nov 2, 1950 .
6 +
Hartung M, Salfelder K:  Histoplasmose mit tödlichem Ausgang als Berufserkrankung bei einem Mykologen . Int Arch Gewerbepath Gewerbehyg 19:270-289, 1962;.
7 +
Vanselow NA, Davey WN, Bocobo FC:  Acute pulmonary histoplasmosis in laboratory workers . J Lab Clin Med 59:236-243, 1962;.
8 +
Nilzen A, Paldrok H:  A laboratory infection caused by Histoplasma capsulatum . Acta Derm Venereol 33:329-341, 1953;.
9 +
Furcolow ML:  Airborne histoplasmosis . Bacteriol Rev 25:301-309, 1961;.
10 +
Dickie HA, Murphy ME:  Laboratory infection with Histoplasma capsulatum . Am Rev Tuberc 72:690-692, 1955;.
11 +
Loosli CG:  Histoplasmosis: Some clinical, epidemiological and laboratory aspects . Med Clin North Am 39:171-200, 1955;.
12 +
Spicknall CG, Ryan WW, Cain A:  Laboratory-acquired histoplasmosis . N Engl J Med 254:210-214, 1956;.
13 +
Fiese MJ: Coccidioidomycosis . Springfield, Charles C Thomas Publisher, 1958;.
14 +
Morris RT:  A case of systemic blastomycosis . JAMA 61:2043-2044, 1913;.
15 +
MacNeal WJ, Hjelm CE:  Note on a mold Coccidioides immitis found in a case of generalized infection in man . JAMA 61:2044, 1913;.
16 +
Hanel E, Kruse RH: Laboratory-acquired mycoses . Miscellaneous publications 28, Frederick, Md, Dept Army Fort Detrick, 1967;.
17 +
Sulkin SE, Pike RM:  Laboratory-acquired infections . JAMA 147:1740-1745, 1951;.
18 +
Smith DT, Harrell ER Jr:  Fatal coccidioidomycosis: A case of a laboratory infection . Am Rev Tuberc 57:368, 1948;.
19 +
Nabarro JDN:  Primary pulmonary coccidioidomycosis: Case of a laboratory infection in England . Lancet 1:982-984, 1948;.
20 +
Bush JD:  Coccidioidomycosis . J Med Assoc State Ala 13:159-166, 1943;.
21 +
Overholt EL, Hornick RB:  Primary cutaneous coccidioidomycosis . Arch Intern Med 114:149-153, 1964;.
22 +
Sorensen RH, Cheu SH:  Accidental cutaneous coccidioidal infection in an immune person . Calif Med 100:44-47, 1964;.
23 +
Trimble JR, Douchette J:  Primary cutaneous coccidioidomycosis: Report of a case of laboratory infection . Arch Dermatol 74:405-410, 1956;.
24 +
Wilson JW, Smith CE:  Primary cutaneous coccidioidomycosis: The criteria for diagnosis . Calif Med 79:233-239, 1953;.
25 +
Brown PK, Cummins WT:  A differential study of coccidioidal granuloma and blastomycosis . Trans Assoc Am Physicians 29:628-650, 1914;.
26 +
Wegmann T, Plempel M:  Das Krankheitsbild der Coccidioidomykose . Dtsch Med Wochenschr 99:1653-1656, 1974;.
27 +
Johnson JE III, Perry JE, Fekety FR, et al:  Laboratory-acquired coccidioidomycosis: A report of 210 cases . Ann Intern Med 60:941-956, 1964;.
28 +
Fava A:  Un cas de sporotrichose conjonctivale et palpebrale primitives . Ann Ocul 141:338-343, 1909;.
29 +
Jeanselme E, Chevallier P:  Transmission de la sporotrichose a l'homme par les morsures d'un rat blanc avec une nouvelle variete de Sporotrichum: lymphagite gommeuse ascendante . Bull Mem Soc Med Hop 31:287-301, 1911;.
30 +
Wilder WH, McCullough CP:  Sporotrichosis of the eye . JAMA 62:1156-1160, 1914;.
31 +
Meyer KF:  The relation of animal to human sporotrichosis . JAMA 65:579-585, 1915;.
32 +
Fielitz H:  Ueber eine Laboratoriumsinfektion mit dem Sporotrichum de Beurmann . Centralbl Baketeriol Orig 55:361-370, 1910;.
33 +
Norden A:  Sporotrichosis: Clinical and laboratory features and a serologic study in experimental animals and humans . Acta Pathol Microbiol 89( (suppl) ):3-119, 1951;.
34 +
Mikkelsen WM, Brandt RL, Harrell ER:  Sporotrichosis: A report of 12 cases, including two with skeletal involvement . Ann Intern Med 47:435-459, 1957;.
35 +
Carougeau M:  Premier cas Africain de sporotrichose de de Beurmann: Transmission de la sporotrichose du mulet a l'homme . Bull Mem Soc Med Hop 28:507-510, 1909;.
36 +
Halde C:  Percutaneous Cryptococcus neoformans inoculation without infection . Arch Dermatol 89:545, 1964;.
37 +
Lurie HI:  Sporotrichosis , in Baker RD: Human Infection With Fungi, Actinomycetes and Algae . New York, Springer-Verlag, 1971;, 614-675.
38 +
Schneidau JD, Lamar LM, Hairston MA Jr:  Cutaneous hypersensitivity to sporotrichin in Louisiana . JAMA 188:371-373, 1964;.
39 +
McDonough ES, Lewis AL, Meister M:  Sporothrix (Sporotrichum) schenckii in a nursery barn containing sphagnum . Public Health Rep 85:579-586, 1970;.
40 +
D'Alessio DJ, Leavens LJ, Strumpf GC, et al:  An outbreak of sporotrichosis in Vermont associated with sphagnum moss as the source of infection . N Engl J Med 272:1054-1058, 1965;.
41 +
Crevasse L, Ellner PD:  An outbreak of sporotrichosis in Florida . JAMA 173:29-33, 1960;.
42 +
Becker FT, Young HR:  Sporotrichosis . Minn Med 53:851-853, 1970;.
43 +
Evers RH, Whereatt RR:  Pulmonary sporotrichosis . Chest 66:91-92, 1974;.
44 +
Taylor A, Blakey D, Phillips B:  Sporotrichosis . Miss Morbid Mortal Wk 26:227-228, 1976;.
45 +
Raphael SS, Schwarz J:  Occupational hazards from fungi causing deep mycoses . Arch Indust Hyg Occup Med 8:154-165, 1953;.
46 +
Ahearn DG, Kaplan W:  Occurrence of Sporotrichum schenckii on a cold-stored meat product . Am J Epidemiol 89:116-124, 1968;.
47 +
Sarosi GA, Parker JD, Tosh FE:  Histoplasmosis outbreaks : Their patterns, in: Proceedings of the Second National Conference on Histoplasmosis . Springfield, Ill, Charles C Thomas Publisher, 1971;, pp 123-128.
48 +
DiSalvo AF:  The role of bats in the ecology of Histoplasma capsulatum , in: Proceedings of the Second National Conference on Histoplasmosis . Springfield, Ill, Charles C Thomas Publisher, 1971;, pp 149-161.
49 +
Gonzalez-Ochoa A:  Relaciones entre el habitat del murcielago y el Histoplasma capsulatum . Rev Inst Salubr Enferm Trop 23:81-86, 1963;.
50 +
Jackson D: Histoplasmosis:  A "spelunker's" risk . Am Rev Respir Dis 83:261-263, 1961;.
51 +
Klite PD, Diercks FH:  Bats and histoplasmosis: A clinicoepidemiologic study of human cases . Ann Intern Med 62:1263-1271, 1965;.
52 +
Taylor RL, Shacklette MH, Kelley HB:  Isolation of Histoplasma capsulatum and Microsporum gypseum from soil and bat guano in Panama and the Canal Zone . Am J Trop Med Hyg 11:790-795, 1962;.
53 +
Garcia Rosell O:  La fiebre de Tingo Maria: Histoplasmosis . Ann Fac Med Lima 38:1083-1091, 1955;.
54 +
Lehan PH, Furcolow ML:  Epidemic histoplasmosis . J Chronic Dis 5:489-503, 1957;.
55 +
Adriano SM, Schwarz J, Silverman FN:  Epidemiologic studies in an outbreak of histoplasmosis . J Lab Clin Med 46:592-596, 1955;.
56 +
Schwarz J, Sethi KK:  Recognition of changing sources in histoplasmic infection . Mycopathologia 37:77-80, 1969;.
57 +
Loosli CG, Grayston JT, Alexander ER, et al:  Epidemiologic studies of pulmonary histoplasmosis in a farm family . Am J Hyg 55:302-401, 1952;.
58 +
Englert E Jr, Phillips AW:  Acute diffuse pulmonary granulomatosis in bridge workers . Am J Med 15:733-740, 1953;.
59 +
Leznoff A, Frank H, Telner P, et al:  Histoplasmosis in Montreal during the fall of 1963, with observation of erythema multiforme . Can Med Assoc J 91:1154-1160, 1964;.
60 +
Wilcox KR Jr, Waisbren BA, Martin J:  The Walworth Wisconsin epidemic of histoplasmosis . Ann Intern Med 49:388-418, 1958;.
61 +
Kier JH, Campbell CC, Ajello L, et al:  Acute bronchopneumonic histoplasmosis following exposure to infected garden soil . JAMA 155:1230-1232, 1954;.
62 +
Scalia SP:  An outbreak of histoplasmosis in Baltimore County . Md State Med J 10:614-619, 1961;.
63 +
Brodsky AL, Gregg MB, Loewenstein MS, et al:  Outbreak of histoplasmosis associated with the 1970 Earth Day activities . Am J Med 54:333-342, 1974;.
64 +
Tosh FE, Doto IL, D'Alessio DJ, et al:  The second of two epidemics of Histoplasmosis resulting from work on the same starling roost . Am Rev Respir Dis 94:406-413, 1966;.
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Tosh FE, Weeks RJ, Pfeiffer FR, et al:  Chemical decontamination of soil containing Histoplasma capsulatum . Am J Epidemiol 83:262-270, 1966;.
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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Larsh HL, Schwarz J:  Accidental inoculation blastomycosis . Cutis 19:334-337, 1977;.
2 +
Baum GL, Lerner PI:  Primary pulmonary blastomycosis: A laboratory acquired infection . Ann Intern Med 73:263-265, 1970;.
3 +
Denton J, DiSalvo AF, Hirsch ML:  Laboratory acquired North American blastomycosis . JAMA 199:935-936, 1967;.
4 +
Furcolow ML, Guntheroth WG, Willis MJ:  The frequency of laboratory infections with Histoplasma capsulatum: Their clinical and X-ray characteristics . J Lab Clin Med 40:182-187, 1952;.
5 +
Smith CE:  The hazard of acquiring mycotic infections in the laboratory . Read before the American Public Health Association Meeting, St. Louis, Nov 2, 1950 .
6 +
Hartung M, Salfelder K:  Histoplasmose mit tödlichem Ausgang als Berufserkrankung bei einem Mykologen . Int Arch Gewerbepath Gewerbehyg 19:270-289, 1962;.
7 +
Vanselow NA, Davey WN, Bocobo FC:  Acute pulmonary histoplasmosis in laboratory workers . J Lab Clin Med 59:236-243, 1962;.
8 +
Nilzen A, Paldrok H:  A laboratory infection caused by Histoplasma capsulatum . Acta Derm Venereol 33:329-341, 1953;.
9 +
Furcolow ML:  Airborne histoplasmosis . Bacteriol Rev 25:301-309, 1961;.
10 +
Dickie HA, Murphy ME:  Laboratory infection with Histoplasma capsulatum . Am Rev Tuberc 72:690-692, 1955;.
11 +
Loosli CG:  Histoplasmosis: Some clinical, epidemiological and laboratory aspects . Med Clin North Am 39:171-200, 1955;.
12 +
Spicknall CG, Ryan WW, Cain A:  Laboratory-acquired histoplasmosis . N Engl J Med 254:210-214, 1956;.
13 +
Fiese MJ: Coccidioidomycosis . Springfield, Charles C Thomas Publisher, 1958;.
14 +
Morris RT:  A case of systemic blastomycosis . JAMA 61:2043-2044, 1913;.
15 +
MacNeal WJ, Hjelm CE:  Note on a mold Coccidioides immitis found in a case of generalized infection in man . JAMA 61:2044, 1913;.
16 +
Hanel E, Kruse RH: Laboratory-acquired mycoses . Miscellaneous publications 28, Frederick, Md, Dept Army Fort Detrick, 1967;.
17 +
Sulkin SE, Pike RM:  Laboratory-acquired infections . JAMA 147:1740-1745, 1951;.
18 +
Smith DT, Harrell ER Jr:  Fatal coccidioidomycosis: A case of a laboratory infection . Am Rev Tuberc 57:368, 1948;.
19 +
Nabarro JDN:  Primary pulmonary coccidioidomycosis: Case of a laboratory infection in England . Lancet 1:982-984, 1948;.
20 +
Bush JD:  Coccidioidomycosis . J Med Assoc State Ala 13:159-166, 1943;.
21 +
Overholt EL, Hornick RB:  Primary cutaneous coccidioidomycosis . Arch Intern Med 114:149-153, 1964;.
22 +
Sorensen RH, Cheu SH:  Accidental cutaneous coccidioidal infection in an immune person . Calif Med 100:44-47, 1964;.
23 +
Trimble JR, Douchette J:  Primary cutaneous coccidioidomycosis: Report of a case of laboratory infection . Arch Dermatol 74:405-410, 1956;.
24 +
Wilson JW, Smith CE:  Primary cutaneous coccidioidomycosis: The criteria for diagnosis . Calif Med 79:233-239, 1953;.
25 +
Brown PK, Cummins WT:  A differential study of coccidioidal granuloma and blastomycosis . Trans Assoc Am Physicians 29:628-650, 1914;.
26 +
Wegmann T, Plempel M:  Das Krankheitsbild der Coccidioidomykose . Dtsch Med Wochenschr 99:1653-1656, 1974;.
27 +
Johnson JE III, Perry JE, Fekety FR, et al:  Laboratory-acquired coccidioidomycosis: A report of 210 cases . Ann Intern Med 60:941-956, 1964;.
28 +
Fava A:  Un cas de sporotrichose conjonctivale et palpebrale primitives . Ann Ocul 141:338-343, 1909;.
29 +
Jeanselme E, Chevallier P:  Transmission de la sporotrichose a l'homme par les morsures d'un rat blanc avec une nouvelle variete de Sporotrichum: lymphagite gommeuse ascendante . Bull Mem Soc Med Hop 31:287-301, 1911;.
30 +
Wilder WH, McCullough CP:  Sporotrichosis of the eye . JAMA 62:1156-1160, 1914;.
31 +
Meyer KF:  The relation of animal to human sporotrichosis . JAMA 65:579-585, 1915;.
32 +
Fielitz H:  Ueber eine Laboratoriumsinfektion mit dem Sporotrichum de Beurmann . Centralbl Baketeriol Orig 55:361-370, 1910;.
33 +
Norden A:  Sporotrichosis: Clinical and laboratory features and a serologic study in experimental animals and humans . Acta Pathol Microbiol 89( (suppl) ):3-119, 1951;.
34 +
Mikkelsen WM, Brandt RL, Harrell ER:  Sporotrichosis: A report of 12 cases, including two with skeletal involvement . Ann Intern Med 47:435-459, 1957;.
35 +
Carougeau M:  Premier cas Africain de sporotrichose de de Beurmann: Transmission de la sporotrichose du mulet a l'homme . Bull Mem Soc Med Hop 28:507-510, 1909;.
36 +
Halde C:  Percutaneous Cryptococcus neoformans inoculation without infection . Arch Dermatol 89:545, 1964;.
37 +
Lurie HI:  Sporotrichosis , in Baker RD: Human Infection With Fungi, Actinomycetes and Algae . New York, Springer-Verlag, 1971;, 614-675.
38 +
Schneidau JD, Lamar LM, Hairston MA Jr:  Cutaneous hypersensitivity to sporotrichin in Louisiana . JAMA 188:371-373, 1964;.
39 +
McDonough ES, Lewis AL, Meister M:  Sporothrix (Sporotrichum) schenckii in a nursery barn containing sphagnum . Public Health Rep 85:579-586, 1970;.
40 +
D'Alessio DJ, Leavens LJ, Strumpf GC, et al:  An outbreak of sporotrichosis in Vermont associated with sphagnum moss as the source of infection . N Engl J Med 272:1054-1058, 1965;.
41 +
Crevasse L, Ellner PD:  An outbreak of sporotrichosis in Florida . JAMA 173:29-33, 1960;.
42 +
Becker FT, Young HR:  Sporotrichosis . Minn Med 53:851-853, 1970;.
43 +
Evers RH, Whereatt RR:  Pulmonary sporotrichosis . Chest 66:91-92, 1974;.
44 +
Taylor A, Blakey D, Phillips B:  Sporotrichosis . Miss Morbid Mortal Wk 26:227-228, 1976;.
45 +
Raphael SS, Schwarz J:  Occupational hazards from fungi causing deep mycoses . Arch Indust Hyg Occup Med 8:154-165, 1953;.
46 +
Ahearn DG, Kaplan W:  Occurrence of Sporotrichum schenckii on a cold-stored meat product . Am J Epidemiol 89:116-124, 1968;.
47 +
Sarosi GA, Parker JD, Tosh FE:  Histoplasmosis outbreaks : Their patterns, in: Proceedings of the Second National Conference on Histoplasmosis . Springfield, Ill, Charles C Thomas Publisher, 1971;, pp 123-128.
48 +
DiSalvo AF:  The role of bats in the ecology of Histoplasma capsulatum , in: Proceedings of the Second National Conference on Histoplasmosis . Springfield, Ill, Charles C Thomas Publisher, 1971;, pp 149-161.
49 +
Gonzalez-Ochoa A:  Relaciones entre el habitat del murcielago y el Histoplasma capsulatum . Rev Inst Salubr Enferm Trop 23:81-86, 1963;.
50 +
Jackson D: Histoplasmosis:  A "spelunker's" risk . Am Rev Respir Dis 83:261-263, 1961;.
51 +
Klite PD, Diercks FH:  Bats and histoplasmosis: A clinicoepidemiologic study of human cases . Ann Intern Med 62:1263-1271, 1965;.
52 +
Taylor RL, Shacklette MH, Kelley HB:  Isolation of Histoplasma capsulatum and Microsporum gypseum from soil and bat guano in Panama and the Canal Zone . Am J Trop Med Hyg 11:790-795, 1962;.
53 +
Garcia Rosell O:  La fiebre de Tingo Maria: Histoplasmosis . Ann Fac Med Lima 38:1083-1091, 1955;.
54 +
Lehan PH, Furcolow ML:  Epidemic histoplasmosis . J Chronic Dis 5:489-503, 1957;.
55 +
Adriano SM, Schwarz J, Silverman FN:  Epidemiologic studies in an outbreak of histoplasmosis . J Lab Clin Med 46:592-596, 1955;.
56 +
Schwarz J, Sethi KK:  Recognition of changing sources in histoplasmic infection . Mycopathologia 37:77-80, 1969;.
57 +
Loosli CG, Grayston JT, Alexander ER, et al:  Epidemiologic studies of pulmonary histoplasmosis in a farm family . Am J Hyg 55:302-401, 1952;.
58 +
Englert E Jr, Phillips AW:  Acute diffuse pulmonary granulomatosis in bridge workers . Am J Med 15:733-740, 1953;.
59 +
Leznoff A, Frank H, Telner P, et al:  Histoplasmosis in Montreal during the fall of 1963, with observation of erythema multiforme . Can Med Assoc J 91:1154-1160, 1964;.
60 +
Wilcox KR Jr, Waisbren BA, Martin J:  The Walworth Wisconsin epidemic of histoplasmosis . Ann Intern Med 49:388-418, 1958;.
61 +
Kier JH, Campbell CC, Ajello L, et al:  Acute bronchopneumonic histoplasmosis following exposure to infected garden soil . JAMA 155:1230-1232, 1954;.
62 +
Scalia SP:  An outbreak of histoplasmosis in Baltimore County . Md State Med J 10:614-619, 1961;.
63 +
Brodsky AL, Gregg MB, Loewenstein MS, et al:  Outbreak of histoplasmosis associated with the 1970 Earth Day activities . Am J Med 54:333-342, 1974;.
64 +
Tosh FE, Doto IL, D'Alessio DJ, et al:  The second of two epidemics of Histoplasmosis resulting from work on the same starling roost . Am Rev Respir Dis 94:406-413, 1966;.
65 +
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66 +
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67 +
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68 +
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