Coccidioidomycosis in acquired immune deficiency syndrome. Depressed humoral as well as cellular immunity.

Progressive pulmonary coccidioidomycosis has not been previously reported in the setting of acquired immune deficiency syndrome (AIDS). A patient with AIDS, progressive pulmonary coccidioidomycosis, Pneumocystis carinii pneumonia, and disseminated cytomegalovirus is described. Diagnosis of these opportunistic pathogens was made by bronchoalveolar lavage and transbronchial lung biopsy. Results of traditional complement fixation serologic testing for cytomegalovirus were negative; however, the more sensitive enzyme-linked immunosorbent assay did indicate infection. Coccidioidal complement fixation tests, precipitin tests, counter-immunoelectrophoresis, and immunodiffusion tests demonstrated negative findings. These results provide additional evidence that some patients with AIDS have defects in humoral as well as cellular immunity.