Dunne W M, Ziebert A P, Donahoe L W, Standard P
Arch Pathol Lab Med. 1986 Mar;110(3):236-8.
Dissemination of coccidioidomycosis beyond the respiratory tract is not uncommon, but involvement of the urogenital tract is rarely observed. Most, if not all, reported cases of urogenital infections caused by Coccidioides immitis have been diagnosed in areas considered endemic for the fungus, where suspicion of this illness and its extrapulmonary manifestations is high. In nonendemic regions, however, C immitis is not likely to be considered as a possible cause of genitourinary tract infections unless the organism is fortuitously identified by histologic, cultural, or serologic studies. We report the unexpected isolation of C immitis from routine bacterial cultures of a draining urethral-scrotal fistula from a patient residing in a nonendemic area of the United States. We also discuss the difficulties and potential hazards encountered during the laboratory evaluation of this case.
球孢子菌病在呼吸道以外传播并不罕见，但泌尿生殖道受累情况很少见。大多数（如果不是全部）由粗球孢子菌引起的泌尿生殖道感染报告病例，都是在该真菌的地方流行区诊断出来的，在这些地区，对这种疾病及其肺外表现的怀疑程度很高。然而，在非流行地区，除非通过组织学、培养或血清学研究偶然鉴定出该病原体，否则粗球孢子菌不太可能被视为泌尿生殖道感染的可能病因。我们报告了从一名居住在美国非流行地区患者的尿道阴囊引流瘘管的常规细菌培养物中意外分离出粗球孢子菌的情况。我们还讨论了该病例实验室评估过程中遇到的困难和潜在风险。
