Final blog post

Thanks everyone for reading my blog I had fun putting the posts together. The semester has ended and so has the class that these blog posts were for. I will not be updating the blog any longer. Thanks for visiting the blog for infectious disease. I hope you enjoyed the posts.

Coccidioides

Coccidioides has been in the news lately. It is causing havoc in the California DOC causing them to have to relocate many prisoners and the rates of diagnosis is increasing as primary care providers are educated on the characteristics of the infection. Annually as many as 150000 people are infected in the US. Most of these people are in the southwest. Rep Kevin McCarthy of California is asking the FDA to add Coccidioides to the list of qualifying pathogens so that it will e more attractive for medical research and better treatments are cures can be found. Currently the standard for diagnosis is fungal culture. This culture can take up to 28 days and is difficult to perform. A recent study,¹ evaluated the ability of PCR detection. In this study the sensitivity and positive predicative value and determined that though they have improved in the last few years they are at 75 and 60% similar with the standard culture methods. Though the positive rates are low the negative predictive value and specificity are each 99%. As these tests are developed they will become cheaper and doctors will become more comfortable is can be used as a test to exclude the diagnosis of Coccidioides.

1  http://link.springer.com/article/10.1007/s11046-010-9327-0#page-1

Toxins make HIV worse

When you think of immunosuppression you think of a few things. First is AIDS or HIV but that is not the only thing that can cause immune suppression. Next is cancer another is other viruses and there are also many chemicals that are known to suppress the immune system. Many have been adapted for therapy weather it is for organ transplants or to treat cancers their use has saved many lives. Rarely thought of is that a fungus can suppress a person’s immune system.  Some very common fungi, members of Aspergillus, produce an aflatoxin which is one of the most carcinogenic substances known. A recent study of 314 Ghanaians showed a correlation between the aflatoxins and severity of HIV. It was shown when the levels of these aflatoxins were higher that the viral load of HIV increased. How can these toxins be avoided. Avoiding them is hard because the fungi that produce them are everywhere and they like to grow in

aflatoxin

grains and beans that are waiting for processing after harvest. In the US we are safe because federal law limits concentrations to 20 in 1 billion but in other areas of the world where much of the processing is not regulated and done by hand concentrations in moldy grain can get as high as 8000 per billion.

http://www.nytimes.com/2013/07/23/health/mold-toxins-tied-to-aids-epidemic.html?_r=1&