Stockamp Nathan W, Thompson George R
Division of Infectious Disease, Department of Internal Medicine, University of California, San Francisco, Fresno, San Francisco, CA, USA.
Division of Infectious Diseases, Department of Internal Medicine, University of California, Davis, Davis, CA, USA; Department of Medical Microbiology and Immunology, University of California, Davis, Davis, CA, USA.
Infect Dis Clin North Am. 2016 Mar;30(1):229-46. doi: 10.1016/j.idc.2015.10.008. Epub 2015 Dec 29.
Coccidioides immitis and C posadasii are pathogenic dimorphic fungi responsible for causing coccidioidomycosis in the Southwestern United States and Central and South America. Antifungal therapy is beneficial and entails careful periodic assessment with therapies ranging from none or short courses of therapy to prolonged antifungal therapy. Factors that influence the decision to treat are the duration or severity of infection, radiographic findings, anticomplementary titers, presence of underlying immunosuppression, and comorbidities. Cure for disseminated infection is infrequent with current treatment regimens. This review summarizes the management guidelines for various disease manifestations and reviews data on challenging cases with newer agents.
粗球孢子菌和波萨达斯球孢子菌是致病性双相真菌,在美国西南部以及中美洲和南美洲可引起球孢子菌病。抗真菌治疗有益,需要进行仔细的定期评估,治疗方法包括不治疗或短期治疗,以及长期抗真菌治疗。影响治疗决策的因素包括感染的持续时间或严重程度、影像学检查结果、抗补体滴度、潜在免疫抑制的存在情况以及合并症。目前的治疗方案很少能治愈播散性感染。本综述总结了各种疾病表现的管理指南,并回顾了使用新型药物治疗疑难病例的数据。