Department of Clinical Microbiology and Immunology, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, India.
Infection. 2012 Dec;40(6):699-702. doi: 10.1007/s15010-012-0315-9. Epub 2012 Aug 17.
Coccidioidomycosis is an endemic disease of the western hemisphere. In cases occurring in non-endemic areas, eliciting a history of exposure as well as a high index of suspicion is imperative for timely and accurate diagnosis. In this case, a 65-year-old male presented to our hospital with fever, dry cough and malaise, and on X-ray chest, was found to have a lower lobe consolidation left lung with nodular lesions in both lungs and necrotic mediastinal lymphadenopathy. He lived in Arizona, USA, for 6 months before admission. Pulmonary coccidioidomycosis was confirmed by the isolation of Coccidioides spp. in pure culture from both broncho-alveolar lavage and lung biopsy specimens. The identity of the isolate was confirmed as C. posadasii by gene sequencing. The patient improved after being treated with fluconazole.
球孢子菌病是西半球的地方性疾病。在非地方性地区发生的病例中，必须询问暴露史，并保持高度怀疑，以便及时准确地诊断。在此例中，一名 65 岁男性因发热、干咳和不适就诊，胸部 X 线片显示左下肺实变，双肺结节状病变和坏死性纵隔淋巴结病。他在入院前在美国亚利桑那州居住了 6 个月。从支气管肺泡灌洗和肺活检标本中均分离出单纯培养的球孢子菌属，从而确诊为肺球孢子菌病。通过基因测序确认该分离株为 C. posadasii。该患者经氟康唑治疗后病情改善。
