Zong Feng, Xie Wei-Ping, Huang Mao, Zhu Quan, Chen Liang, Zhang Zhi-Hong
Department of Respiratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2010 Mar;33(3):193-6.
To improve the understanding of the clinical manifestations of pulmonary coccidioidomycosis.
A case of pulmonary coccidioidomycosis was reported, and the literature was reviewed. The epidemiologic, clinical and diagnostic aspects of coccidioidomycosis were discussed.
A 74 year old male was admitted to the hospital because of physical examination revealing lung space occupying lesions for 9 months and cough for 2 weeks. Lung puncture biopsy was carried out and the diagnosis of cryptococcosis was established in another hospital. After 6 months' therapy with fluconazole, the chest CT showed no change. After being hospitalized, thoracoscopic wedge resection of lung was performed and the final diagnosis was pulmonary coccidioidomycosis. After the surgery, he was immediately started on voriconazole 200 mg daily for 1 month. Then oral fluconazole was prescribed for 5 months. A follow-up chest CT performed 6 months after surgery was normal.
Coccidioidomycosis is uncommon. It's pathological appearance is similar to cryptococcus. With the extensive using of immune suppressive drugs, we should improve the recognition of coccidioidomycosis.
提高对肺球孢子菌病临床表现的认识。
报告1例肺球孢子菌病病例并复习文献,讨论球孢子菌病的流行病学、临床及诊断方面。
1例74岁男性因体检发现肺部占位性病变9个月、咳嗽2周入院。在外院行肺穿刺活检,诊断为隐球菌病。氟康唑治疗6个月后,胸部CT无变化。入院后行胸腔镜肺楔形切除术,最终诊断为肺球孢子菌病。术后立即开始口服伏立康唑200mg/d,共1个月。然后口服氟康唑5个月。术后6个月复查胸部CT正常。
球孢子菌病并不常见,其病理表现与隐球菌相似。随着免疫抑制药物的广泛应用,应提高对球孢子菌病的认识。