Buijze Geert A, Kok Petra, Botha-Scheepers Stella A, Smith Sierd J, Sleeboom Harm P
Department of General Internal Medicine, Haga Ziekenhuis, Leyweg 275, 2545 CH, Den Haag, The Netherlands.
Eur J Intern Med. 2009 May;20(3):319-22. doi: 10.1016/j.ejim.2008.08.014. Epub 2008 Oct 18.
We report the case of a 58 year old male patient with nonproductive coughing, fever, vomiting and loss of appetite, beginning at the moment that he returned back home from a 2 week holiday in California. His symptoms were accompanied by increased inflammatory markers in his blood (leucocytosis, high CRP) and pulmonary sequelae, becoming more prominent shortly after admission. Eventually, the final diagnosis of coccidioidomycosis was made by histopathology and confirmed by serology. Coccidioidomycosis is a rare infectious disease. However, the incidence in the endemic areas of this fungal infection is increasing and the population travelling towards its specific endemic regions in the United States and Southern America is considerably growing. Clinicians facing patients with pulmonary infection with the appropriate travel history and persistent pulmonary or systemic infection (with or without eosinophilia) should be alert to the possibility of coccidioidomycosis. Therefore, we present an up to date overview of the epidemiology, microbiology, clinical features, diagnosis and treatment of patients with coccidioidomycosis.
我们报告了一例58岁男性患者的病例，该患者从加利福尼亚州为期两周的假期返回家中后，开始出现干咳、发热、呕吐和食欲不振的症状。他的症状伴有血液中炎症标志物升高（白细胞增多、高CRP）和肺部后遗症，入院后不久变得更加明显。最终，通过组织病理学做出了球孢子菌病的最终诊断，并通过血清学得到证实。球孢子菌病是一种罕见的传染病。然而，这种真菌感染的流行地区的发病率正在上升，前往美国和南美洲特定流行地区的人口也在大幅增长。面对有适当旅行史且患有肺部感染以及持续肺部或全身感染（伴有或不伴有嗜酸性粒细胞增多）的患者，临床医生应警惕球孢子菌病的可能性。因此，我们对球孢子菌病患者的流行病学、微生物学、临床特征、诊断和治疗进行了最新概述。
