Kwok Henry K H, Chan Johnny W M, Li Iris W S, Chu Stephanie Y Y, Lam Chak Wah
Hospital Authority Head Office, Queen Elizabeth Hospital, University of Hong Kong, Hong Kong, China.
Respirology. 2009 May;14(4):617-20. doi: 10.1111/j.1440-1843.2008.01407.x.
Coccidioidomycosis is endemic in the south-western USA. Two cases of infection in travellers returning to Hong Kong are described. A previously healthy patient who had travelled to an endemic area for a short time was successfully treated with fluconazole. A second patient with comorbidities and more prolonged exposure had disseminated and eventually fatal disease, despite prolonged administration of anti-fungal agents. Although coccidioidomycosis is a rare disease in Hong Kong, it should always be considered when there is a relevant travel history. Even a short period of travel to an endemic area should alert clinicians to this possibility when managing patients with severe pneumonia, especially those with multi-organ involvement. On the other hand, in patients with comorbidities, even aggressive and prolonged anti-fungal therapy may not guarantee a successful outcome.
球孢子菌病在美国西南部为地方病。本文描述了两例返回香港的旅行者感染病例。一名此前健康的患者前往地方病流行区短时间旅行，接受氟康唑治疗后康复。第二名患者患有合并症且接触时间更长，尽管长期使用抗真菌药物，仍发生了播散性感染并最终死亡。虽然球孢子菌病在香港是一种罕见疾病，但当患者有相关旅行史时，应始终予以考虑。即使在地方病流行区短期旅行，临床医生在治疗重症肺炎患者，尤其是有多器官受累的患者时，也应警惕这种可能性。另一方面，对于患有合并症的患者，即使积极且长期进行抗真菌治疗也未必能确保成功治愈。
