Coccidoidouria: clinical significance.

Twelve patients had urine cultures positive for Coccidioides immitis. Ten patients showed the usual criteria for dissemination, but 2 were believed, before urine culture, to have only chronic pulmonary involvement. In 8 patients, there was impairment of host defense mechanisms due either to associated disease or immunosuppressive drug therapy. Only 2 of 11 patients tested reacted to coccidioidin skin-test antigen. Colony counts of C. immitis in the first voided morning urine spacimens ranged from 0.03/ml to 17/ml. With prostatic involvement, colony counts in the expressed secretions ranged from 15/ml to 120/ml. The site of urinary tract coccidioidomycosis, which could be adduced in 9 patients, was the upper tract in 1, lower tract in 6, and in both upper and lower tracts in 2. In patients with lower tract infection, the prostate was involved in 4 and the epididymis in 2.