CHRONIC COCCIDIOIDAL SYNOVITIS OF THE KNEE JOINT*

Coccidioidomycosis is an infection caused by the fungus Coccidioides imrnitis. The disease was first recogmiized in 1892 in Buenos Aires by Posadas and by Wernicke, and subsequently cases were described in California in 1894 by Rixford. The organism was identified as a fungus and cultured by Oph#{252}lsand Moffit in 1900. The disease is endemic in Southern California and Arizona, where the climate is characterized by long, hot, dry, dusty summers and a low annual rainfall. Recently it has been reported in the northwestern part of Mexico.t8 During World War II many troops stationed in endemic regions contracted this infection. The disease resembles tuberculosis and may indeed be confused with it, both histologically and clinically. The site of primary infection is usually the lungs, but occasionally the point of entrance is the skin or possibly the tonsils; in the latter case cervical adenitis results. Primary coccid-ioidomycosis, the so-called “ Valley fever “, “ Desert fever “, or “ San Joaquin Valley fever”, is ami acute, usually benign, pulmonary infection. It is characterized by malaise, anorexia, chills, fever, headache, night sweats, and pleurisy. Roentgenograms show hilar or peribronchial thickemiing and pneumonitis, and the larger lesions show actual cavita