Zhu Cui, Wang Ge, Chen Qiong, He Bixiu, Wang Lijing
Department of Gerontology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China.
Department of Information and Technology Services, Zhengzhou Maternal and Child Health Hospital, Zhengzhou, Henan 450012, P.R. China.
Exp Ther Med. 2016 Nov;12(5):3256-3260. doi: 10.3892/etm.2016.3774. Epub 2016 Oct 4.
In the present study, the case of a 54-year-old male patient diagnosed with pulmonary histoplasmosis is reported, with the aim to increase the understanding of the disease characteristics and thereby facilitate the diagnosis and treatment of pulmonary histoplasmosis. Clinical manifestations, diagnosis, treatment and clinical outcomes of the present case of pulmonary histoplasmosis were described. In addition, 76 histoplasmosis patients with complete clinical data were reviewed by searching the literature for relevant studies published during 1990 and 2015. The disease was mainly manifested as cough in the present case, while imaging examination detected a lump shadow in the right lung, accompanied by exudative lesions. Initially, the patient was suspected to have bacterial pneumonia, but subsequently the diagnosis of pulmonary histoplasmosis was confirmed by lung biopsy. The symptoms were alleviated following itraconazole treatment. The patient was physically stable and had no recurrence during the subsequent follow-up period. In conclusion, pulmonary histoplasmosis is characterized by non-specific clinical and imaging manifestations, and lung tissue biopsy or respiratory pathogen culture are regarded as the diagnostic gold standards. Individualized antifungal medication should be administered based upon the patients' situation in terms of dosage and duration.
本研究报告了一例54岁男性肺组织胞浆菌病患者的病例,旨在提高对该病特征的认识,从而促进肺组织胞浆菌病的诊断和治疗。描述了本例肺组织胞浆菌病的临床表现、诊断、治疗及临床结局。此外,通过检索1990年至2015年期间发表的相关研究文献,对76例有完整临床资料的组织胞浆菌病患者进行了回顾。本病例中疾病主要表现为咳嗽,影像学检查发现右肺有肿块阴影,并伴有渗出性病变。最初,患者被怀疑患有细菌性肺炎,但随后经肺活检确诊为肺组织胞浆菌病。伊曲康唑治疗后症状缓解。患者身体状况稳定,在随后的随访期间无复发。总之,肺组织胞浆菌病具有非特异性的临床和影像学表现,肺组织活检或呼吸道病原体培养被视为诊断的金标准。应根据患者情况在剂量和疗程方面给予个体化抗真菌药物治疗。