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以色列旅行者中的组织胞浆菌病。

Histoplasmosis in Israeli travelers.

作者信息

Segel Michael J, Rozenman Judith, Lindsley Mark D, Lachish Tamar, Berkman Neville, Neuberger Ami, Schwartz Eli

机构信息

Institute of Pulmonology, Department of Imaging, Internal Medicine "C" and Center for Geographic Medicine, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel; Sackler Medical School, Tel Aviv University, Tel Aviv, Israel; Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Infectious Diseases Unit, Shaare-Zedek Medical Center, Jerusalem, Israel; Institute of Pulmonology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Unit of Infectious Diseases, Internal Medicine B, Rambam Medical Center, Haifa, Israel.

Institute of Pulmonology, Department of Imaging, Internal Medicine "C" and Center for Geographic Medicine, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel; Sackler Medical School, Tel Aviv University, Tel Aviv, Israel; Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Infectious Diseases Unit, Shaare-Zedek Medical Center, Jerusalem, Israel; Institute of Pulmonology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Unit of Infectious Diseases, Internal Medicine B, Rambam Medical Center, Haifa, Israel

出版信息

Am J Trop Med Hyg. 2015 Jun;92(6):1168-72. doi: 10.4269/ajtmh.14-0509. Epub 2015 Apr 27.

Abstract

Histoplasmosis is a common endemic human mycoses acquired mostly in the Americas. We reviewed 23 cases of histoplasmosis in Israeli travelers; 22 had traveled to Central or South America and one to North America. Fourteen cases had been exposed to bat habitats and were symptomatic, presenting ≤ 3 months after their return. Asymptomatic patients (N = 9) were diagnosed during the evaluation of incidental radiological findings or because a travel partner had been suspected of Histoplasma infection, 16-120 months after their return. Serological testing was positive in 75% of symptomatic cases but only 22% of asymptomatic cases. Histoplasmosis should be considered in travelers returning from the Americas with respiratory or febrile illness within weeks of return, particularly if exposed to bat habitats. Travel history is essential in patients presenting with pulmonary nodules, even years after travel to endemic countries.

摘要

组织胞浆菌病是一种常见的地方性人类真菌病,主要在美洲地区感染。我们回顾了23例以色列旅行者患组织胞浆菌病的病例;其中22人前往中美洲或南美洲旅行,1人前往北美洲旅行。14例患者曾接触过蝙蝠栖息地且出现症状,在返回后≤3个月发病。无症状患者(n = 9)在对偶然的影像学检查结果进行评估时被诊断出来,或者因为旅行伙伴被怀疑感染组织胞浆菌而被诊断,这发生在他们返回后的16 - 120个月。75%的有症状病例血清学检测呈阳性,但无症状病例中只有22%呈阳性。对于从美洲返回且在返回几周内出现呼吸道疾病或发热的旅行者,应考虑组织胞浆菌病,特别是如果他们接触过蝙蝠栖息地。对于出现肺结节的患者,即使在前往流行国家数年之后,旅行史也至关重要。

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