美国西南部温泉中获得的严重皮肤和软组织芽生菌病，病例报告及北美病例回顾。
Severe skin and soft tissue pythiosis acquired in a hot spring in the southwestern United States, a case report and review of North American cases.
机构信息
Infectious Disease Service, Tripler Army Medical Center, 1 Jarrett White Rd, Honolulu, HI, 96859, USA.
Department of Pathology, William Beaumont Army Medical Center, 18511 Highlander Medics St, Ft Bliss, TX, 79918, USA.
出版信息
Travel Med Infect Dis. 2022 Jul-Aug;48:102349. doi: 10.1016/j.tmaid.2022.102349. Epub 2022 Apr 29.
BACKGROUND
Human pythiosis, caused primarily by the aquatic oomycete, Pythium insidiosum, is an emerging but uncommon infection in North America. The infection is frequently life-threatening and is often initially unrecognized due to its rarity and similar presentation to certain fungal infections.
METHODS
We report a case of skin and soft tissue pythiosis in a patient without significant underlying comorbidities acquired in a New Mexico hot spring and review its successful treatment. We also review all reported pythiosis cases in North America.
RESULTS
Eleven confirmed cases of human pythiosis acquired in North America were identified. The majority of cases occurred in children (64%), ten of eleven cases were acquired in the southern U.S., Mexico, Central America or the Caribbean and four of the eleven individuals succumbed to the infection.
CONCLUSIONS
With recognition and aggressive surgical and medical treatment good clinical outcomes can be achieved when treating human pythiosis.
背景
人类的嗜热真菌病主要由水生卵菌，即嗜热真菌引起，是北美的一种新出现但不常见的感染。由于其罕见性和与某些真菌感染相似的表现，这种感染通常具有致命性，且往往最初未被识别。
方法
我们报告了一例在新墨西哥州温泉中获得的无明显基础合并症的皮肤和软组织嗜热真菌病患者，并对其成功治疗进行了回顾。我们还回顾了所有在北美的嗜热真菌病病例报告。
结果
共确定了 11 例在北美的确诊人类嗜热真菌病病例。大多数病例发生在儿童中（64%），11 例中有 10 例发生在美国南部、墨西哥、中美洲或加勒比地区，11 例中有 4 例死亡。
结论
通过识别和积极的手术及药物治疗，在治疗人类嗜热真菌病时可以获得良好的临床结果。
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