Dworkin Mark S, Duckro Amy N, Proia Laurie, Semel Jeffery D, Huhn Greg
Illinois Department of Public Health, Div. of Infectious Diseases, Chicago, Illinois 60601, USA.
Clin Infect Dis. 2005 Dec 15;41(12):e107-11. doi: 10.1086/498152. Epub 2005 Nov 9.
Blastomycosis is a systemic fungal disease that may be asymptomatic or progressive and may lead to death.
In response to a reported increase in the number of cases of blastomycosis in Illinois, surveillance data reported to the Illinois Department of Public Health from January 1993 to August 2003 were analyzed and the medical records of 4 patients who died were reviewed.
Among the 500 cases reported, the median age of the patients was 43 years (range, 4-87 years), and 34 patients (7%) died. Higher rates of mortality were observed among persons who were black, who were > or =65 years of age, and who were male. The median time from onset of illness to diagnosis was 128 days (range, 12-489 days). Death was associated with a time from onset of illness to diagnosis of > or =128 days (OR, 2.1; 95% CI, 1.0-4.8). During the period from 1993 through 2002, the number of cases reported per year increased from 24 to 87 (P<.05).
The incidence of blastomycosis has been increasing in Illinois. To reduce mortality related to delay in diagnosis and treatment, medical providers need to be educated about blastomycosis, with an emphasis on symptom recognition, methods of diagnosis, and appropriate antifungal treatment.
芽生菌病是一种全身性真菌疾病，可能无症状或呈进行性发展，甚至可能导致死亡。
针对伊利诺伊州报告的芽生菌病病例数增加的情况，分析了1993年1月至2003年8月向伊利诺伊州公共卫生部报告的监测数据，并回顾了4例死亡患者的病历。
在报告的500例病例中，患者的中位年龄为43岁（范围为4至87岁），34例（7%）死亡。黑人、年龄≥65岁者及男性的死亡率较高。从发病到诊断的中位时间为128天（范围为12至489天）。死亡与从发病到诊断的时间≥128天相关（比值比，2.1；95%可信区间，1.0至4.8）。在1993年至2002年期间，每年报告的病例数从24例增加到87例（P<0.05）。
伊利诺伊州芽生菌病的发病率一直在上升。为降低与诊断和治疗延迟相关的死亡率，需要对医疗服务提供者进行芽生菌病相关教育，重点是症状识别、诊断方法和适当的抗真菌治疗。
