Rapid Diagnosis of Pulmonary Coccidioidomycosis: Cytologic v Potassium Hydroxide Preparations

In 26 patients with culture-proved pulmonary coccidioidomycosis, cytologic preparations of respiratory secretions were significantly more sensitive (38.5%) than potassium hydroxide (KOH) preparations (15.4%) in identifying spherules of Coccidioides immitis. Those patients able to produce sputum or having multiple-lobe pneumonitis on chest roentgenogram appeared to be more likely to have spherules identified in the sputum by either technique. In the absence of sputum production or multiple-lobe pneumonitis, neither cytologic nor KOH preparations were likely to disclose spherules. Because of its greater sensitivity, a cytologic preparation should be examined in addition to a KOH preparation when pulmonary coccidioidomycosis is a clinical consideration.