Kim Michelle M, Blair Janis E, Carey Elizabeth J, Wu Qing, Smilack Jerry D
Mayo Clinic, Scottsdale, Arizona 85259, USA.
Emerg Infect Dis. 2009 Mar;15(3):397-401. doi: 10.3201/eid1563.081007.
Community-acquired pneumonia (CAP) often results in severe illness and death. In large, geographically defined areas where Coccidioides spp. are endemic, coccidioidomycosis is a recognized cause of CAP, but its frequency has not been studied extensively. To determine the frequency of patients with coccidioidomycosis, we conducted a prospective evaluation of 59 patients with CAP in the Phoenix, Arizona, area. Of 35 for whom paired coccidioidal serologic testing was performed, 6 (17%) had evidence of acute coccidioidomycosis. Coccidioidal pneumonia was more likely than noncoccidioidal CAP to produce rash. The following were not found to be risk factors or reliable predictors of infection: demographic features, underlying medical conditions, duration of time spent in disease-endemic areas, occupational and recreational activities, initial laboratory studies, and chest radiography findings. Coccidioidomycosis is a common cause of CAP in our patient population. In the absence of distinguishing clinical features, coccidioidal pneumonia can be identified only with appropriate laboratory studies.
社区获得性肺炎（CAP）常导致严重疾病和死亡。在球孢子菌属地方流行的广大地理区域，球孢子菌病是CAP的一个公认病因，但尚未对其发病率进行广泛研究。为确定球孢子菌病患者的发病率，我们对亚利桑那州凤凰城地区59例CAP患者进行了前瞻性评估。在35例进行了配对球孢子菌血清学检测的患者中，6例（17%）有急性球孢子菌病的证据。球孢子菌肺炎比非球孢子菌性CAP更易出现皮疹。未发现以下因素是感染的危险因素或可靠预测指标：人口统计学特征、基础疾病、在疾病流行地区停留的时间、职业和娱乐活动、初始实验室检查以及胸部X线检查结果。在我们的患者群体中，球孢子菌病是CAP的常见病因。在缺乏特征性临床特征的情况下，只有通过适当的实验室检查才能识别球孢子菌肺炎。
