Valdivia Lisa, Nix David, Wright Mark, Lindberg Elizabeth, Fagan Timothy, Lieberman Donald, Stoffer T'Prien, Ampel Neil M, Galgiani John N
University of Arizona College of Medicine, Tucson, Arizona 85723, USA.
Emerg Infect Dis. 2006 Jun;12(6):958-62. doi: 10.3201/eid1206.060028.
The early manifestations of coccidioidomycosis (valley fever) are similar to those of other causes of community-acquired pneumonia (CAP). Without specific etiologic testing, the true frequency of valley fever may be underestimated by public health statistics. Therefore, we conducted a prospective observational study of adults with recent onset of a lower respiratory tract syndrome. Valley fever was serologically confirmed in 16 (29%) of 55 persons (95% confidence interval 16%-44%). Antimicrobial medications were used in 81% of persons with valley fever. Symptomatic differences at the time of enrollment had insufficient predictive value for valley fever to guide clinicians without specific laboratory tests. Thus, valley fever is a common cause of CAP after exposure in a disease-endemic region. If CAP develops in persons who travel or reside in Coccidioides-endemic regions, diagnostic evaluation should routinely include laboratory evaluation for this organism.
球孢子菌病（山谷热）的早期表现与社区获得性肺炎（CAP）的其他病因相似。若没有进行特定的病因检测，公共卫生统计数据可能会低估山谷热的实际发病率。因此，我们对近期出现下呼吸道综合征的成年人开展了一项前瞻性观察研究。55名患者中有16名（29%）经血清学确诊为山谷热（95%置信区间为16%-44%）。81%的山谷热患者使用了抗菌药物。在未进行特定实验室检测的情况下，入组时的症状差异对山谷热的预测价值不足，无法指导临床医生。因此，在疾病流行地区接触后，山谷热是CAP的常见病因。如果前往球孢子菌流行地区旅行或居住的人患上CAP，诊断评估应常规包括针对该病原体的实验室评估。
