Outbreaks have further defined the geographic distribution of Coccidioides, initially identified in part by large-scale coccidioidin
skin test surveys (13).
(2) Routine skin testing with coccidioidin
(spherulin) in coccidioidomycosisendemic areas is not predictive of disease and should not be performed (Ell).
The first complete description of the geographic distribution of coccidioidomycosis was accomplished through large-scale evaluations of coccidioidin
immitis by positive coccidioidin
or spherulin skin tests.
In brief, we incubated 0.5 mL of whole peripheral blood with 5 pg of coccidioidin
filtrate (provided by Mitch Magee, Arizona State University, Tempe, AZ, USA) for 24 h at 37[degrees]C in a humidified incubator containing 5% C[O.sub.2].
The mycosis is presently considered to be endemic to Northeast Brazil, as evidenced by human autochthonous cases (6-8), positive coccidioidin
skin-test results (7), and isolation of the fungus from soil (7,9).
Histoplasmin and coccidioidin
sensitivity among students in Taiwan.