Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuo-Ku, Chiba, 260-8670, Japan.
Department of Thoracic Surgery, International University of Health and Welfare School of Medicine, Chiba, Japan.
Surg Today. 2024 Apr;54(4):325-330. doi: 10.1007/s00595-023-02736-3. Epub 2023 Aug 9.
Coccidioidomycosis, caused by the Coccidioides species, is a well-known disease in the Southwestern United States and North Mexico, with scattered reports in Latin America countries. While this disease is still rare in Japan and other Asian countries, its incidence has been increasing over the last two decades. Coccidioides species are highly infectious and require caution when encountered. This study presents a case series of chronic pulmonary coccidioidomycosis surgically treated at a single institution.
We conducted a retrospective chart review of six patients who underwent lung resection for pulmonary coccidioidomycosis at Chiba University Hospital between January 2007 and December 2021.
All six patients had travelled to the Southwestern United States. Preoperative serology was negative for the anti-Coccidioides antibody in four patients and positive in two. Chest computed tomography revealed a single, well-defined round nodule in all patients. Preoperative biopsy taken from three patients failed to obtain a definitive diagnosis. Histopathological examination of the resected pulmonary nodules revealed granulomas that contained numerous spherules with many endospores, thereby confirming the diagnosis of pulmonary coccidioidomycosis.
Pulmonary coccidioidomycosis should be suspected based on travel history and radiological findings. Meticulous care should be taken during specimen processing to prevent cross infection.
由粗球孢子菌引起的球孢子菌病是美国西南部和墨西哥北部众所周知的疾病，在拉丁美洲国家也有零星报告。虽然这种疾病在日本和其他亚洲国家仍然很少见，但在过去二十年中其发病率一直在增加。粗球孢子菌具有高度传染性，遇到时需要谨慎。本研究介绍了在一家医疗机构接受手术治疗的慢性肺球孢子菌病的病例系列。
我们对 2007 年 1 月至 2021 年 12 月期间在千叶大学医院接受肺切除术治疗肺球孢子菌病的 6 名患者进行了回顾性图表审查。
所有 6 名患者均有前往美国西南部的旅行史。4 名患者的术前血清抗粗球孢子菌抗体检测为阴性，2 名患者为阳性。胸部计算机断层扫描显示所有患者均有单个界限清楚的圆形结节。3 名患者的术前活检未能获得明确诊断。切除的肺结节的组织病理学检查显示含有许多内生孢子的大量球体的肉芽肿，从而确认了肺球孢子菌病的诊断。
根据旅行史和影像学发现应怀疑患有肺球孢子菌病。在标本处理过程中应格外小心，以防止交叉感染。
