. The American journal of roentgenology, radium therapy and nuclear medicine . *FiG. 4. Showing THE .Microscopic .\iiEAKANCE ofTHE Growth .\s it Appears ox .Artificial CultureMedia. * Plates fvirnished by Dr. Charles W. Bonynge, Bacteriologist, Los Angeles, Calif. Coccidioidal Granuloma 549 helping with the bean crop, mostly as athreshing hand. His general condition became rapidlyworse, his temperature being elevated ° in the afternoons with a morningtemperature usually around 99° and 100°.Pulse rate increased from 90 to 120 beforeoperation, performed by Dr. R. on Feb. 15,1916, when a c
. The American journal of roentgenology, radium therapy and nuclear medicine . *FiG. 4. Showing THE .Microscopic .\iiEAKANCE ofTHE Growth .\s it Appears ox .Artificial CultureMedia. * Plates fvirnished by Dr. Charles W. Bonynge, Bacteriologist, Los Angeles, Calif. Coccidioidal Granuloma 549 helping with the bean crop, mostly as athreshing hand. His general condition became rapidlyworse, his temperature being elevated ° in the afternoons with a morningtemperature usually around 99° and 100°.Pulse rate increased from 90 to 120 beforeoperation, performed by Dr. R. on Feb. 15,1916, when a curettage of the bone of theankle joint was done. Nothing was re-. FiG. 5. Case I. (Patient90968). Rich 1 Ankle ShowingInvolvement of the Internal Malleolus andInternal Two-thirds of Articular Surface ofthe Tibia. moved but bloody granular tissue, thejoint being drained with a through andthrough drain. Microscopic examinationof the curettings on section showed chronicinflammation with giant cell showed staphylococcus growth,and a diagnosis was then made of tuber-culosis of the joint with secondary infec-tion. Patients condition grew steadily worse,the right ankle becoming involved a shorttime later, and on March 21, 1916, again operated, doing a curettementof both the right and left ankle joints,removing necrosed bone and pus. Patientsgeneral condition rapidly became findings from the resultsof the second operation were chronic granulation with endospore cells foundresembUng coccidioidal granuloma, giantcells being present in goodly number; anda diagnosis of coccidioidal granuloma wasmade. Guinea pig inocu
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