Batra P
Department of Radiological Sciences, University of California, Los Angeles School of Medicine 90024.
J Thorac Imaging. 1992 Sep;7(4):29-38. doi: 10.1097/00005382-199209000-00006.
Coccidioidomycosis is a fungal disease endemic in the southwestern desert area of the United States. The infection is acquired by inhalation of arthrospores, and 60% of the infections are asymptomatic. Chest radiographic abnormalities are common and may even be seen in asymptomatic cases. In patients with acute infection, segmental or lobar consolidation and nodular or patchy pulmonary opacities are frequent. Hilar and mediastinal adenopathy may be present in 20% of cases, usually with parenchymal findings. A small pleural effusion may occur in 20% of cases. Approximately 5% of patients with primary disease are left with chronic, residual lesions of the lung. These consist of nodules, cavities, pneumonia, adenopathy, pleural effusion, fibrosis, bronchiectasis, and calcification. Rarely, in about 0.5% of cases, the infection may disseminate to any organ. The chest radiograph demonstrates a miliary or reticulonodular pattern and mediastinal adenopathy. Overall the disease is benign in nature; but patients with severe, progressive pulmonary or disseminated disease often require medical and occasionally surgical management.
球孢子菌病是一种在美国西南部沙漠地区流行的真菌病。感染是通过吸入关节孢子获得的，60%的感染是无症状的。胸部X线异常很常见，甚至在无症状病例中也可见。在急性感染患者中，节段性或大叶性实变以及结节状或斑片状肺部混浊很常见。20%的病例可能出现肺门和纵隔淋巴结肿大，通常伴有实质病变。20%的病例可能出现少量胸腔积液。大约5%的原发性疾病患者会留下肺部慢性残留病变。这些病变包括结节、空洞、肺炎、淋巴结肿大、胸腔积液、纤维化、支气管扩张和钙化。在大约0.5%的病例中，感染很少会扩散到任何器官。胸部X线片显示粟粒状或网状结节状阴影以及纵隔淋巴结肿大。总体而言，这种疾病本质上是良性的；但患有严重、进行性肺部或播散性疾病的患者通常需要药物治疗，偶尔还需要手术治疗。
