Immunology

Cell-mediated immunity is crucial in host defense. Inhalation of spores causes patchy areas of pneumonitis. The spores are transformed into the yeast form, which is engulfed by macrophages. The yeasts multiply intracellularly with a generation time of 11 hom*s (Howard 1965). The regional lymph nodes are quickly involved, and hematogenous spread occurs. The fungus is cleared from the blood by reticuloendothelial cells throughout the body. Specific cell-mediated immunity develops and rapidly checks the infection in the lung and at distant sites. Granuloma formation and necrosis occur at sites of infection.

Humoral antibody also develops. Although circulating antibodies are the basis of many diagnostic tests, they have little importance in limiting the infection. Hyperimmune serum is of no benefit in experimental infections, and hypogammaglobulin-emic patients are not prone to progressive infections.

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