Department of Internal Medicine, Division of Infectious Diseases, University of California Davis Medical Center, 4150 V Street, PSSB, Suite G500, Sacramento, CA 95817, USA.
Department of Internal Medicine, Division of Infectious Diseases, University of California Davis Medical Center, 4150 V Street, PSSB, Suite G500, Sacramento, CA 95817, USA; Department of Medical Microbiology and Immunology, University of California, Davis, Davis, CA, USA.
Infect Dis Clin North Am. 2021 Jun;35(2):453-469. doi: 10.1016/j.idc.2021.03.010.
Coccidioidomycosis, caused by the dimorphic pathogenic fungi Coccidioides immitis and Coccidioides posadassi, is endemic to the southwestern United states and Central and South America. The incidence of coccidioidomycosis continues to increase. Coccidioidomycosis is typically a self-limiting influenza-like respiratory illness; however, it can lead to disseminated disease outside of the lungs. Not all nondisseminated cases require therapy, but antifungal therapy is typically beneficial requiring treatment ranging from months to lifelong. Clinical factors related to treatment decisions include severity of symptoms, radiography, coccidioidomycosis serologic results, and concurrent medical problems including immunosuppression. This review summarizes the epidemiology, clinical manifestations, and treatment options.
球孢子菌病由二态致病真菌荚膜组织胞浆菌和波萨达斯荚膜组织胞浆菌引起，流行于美国西南部和中美洲及南美洲。球孢子菌病的发病率持续增加。球孢子菌病通常是一种自限性流感样呼吸道疾病；然而，它也可能导致肺部以外的播散性疾病。并非所有非播散性病例都需要治疗，但抗真菌治疗通常是有益的，需要治疗时间从数月到终身不等。与治疗决策相关的临床因素包括症状严重程度、影像学检查、球孢子菌血清学结果以及包括免疫抑制在内的并存医学问题。这篇综述总结了球孢子菌病的流行病学、临床表现和治疗选择。
