Reyes-Montes María Del Rocío, León-García Adriana Anel, Frías-De-León María Guadalupe, Acosta-Altamirano Gustavo, Sánchez-Saavedra Erika Paola, Victoriano-Pastelín Isai, Meraz-Ríos Beatriz, Duarte-Escalante Esperanza
Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad Universitaria, Coyoacán, Ciudad de Mexico 04510, Mexico.
Hospital Regional de Alta Especialidad de Ixtapaluca, Unidad de Investigación Biomédica, Pueblo de Zoquiapan, Ixtapaluca 56530, Mexico.
Life (Basel). 2023 Oct 24;13(11):2109. doi: 10.3390/life13112109.
Coccidioidomycosis, caused by and , causes significant morbidity and mortality, both in immunocompetent and immunocompromised people, mainly in endemic areas. The present work analyzed its epidemiology, diagnostic methods, and treatment by reviewing clinical cases published from 1950 to 2021. Fifty-nine articles were included, corresponding to 275 clinical cases. The results showed a higher incidence of coccidioidomycosis in the male gender than the female gender. The most affected age group was 31-40 years, and the most reported clinical presentation was disseminated with greater involvement in cutaneous and subcutaneous tissue, followed by the CNS, bone system, and peritoneum. The species most frequently reported was . The most used treatment was azoles, followed by their combination with amphotericin B, monotherapy with amphotericin B, and alternative medicine. This work shows that epidemiological data outside the USA are still scarce. Serological tests are the preferred diagnostic method in daily medical practice, and cultures remain the gold standard. The treatment for coccidioidomycosis is ketoconazole and amphotericin B, individually or in combination.
球孢子菌病由[具体病原体1]和[具体病原体2]引起，在免疫功能正常和免疫功能低下的人群中均会导致显著的发病率和死亡率，主要发生在流行地区。本研究通过回顾1950年至2021年发表的临床病例，分析了其流行病学、诊断方法和治疗情况。纳入了59篇文章，对应275例临床病例。结果显示，男性球孢子菌病的发病率高于女性。受影响最严重的年龄组为31 - 40岁，最常报告的临床表现为播散性，皮肤和皮下组织受累较多，其次是中枢神经系统、骨骼系统和腹膜。最常报告的菌种是[具体菌种]。最常用的治疗方法是唑类药物，其次是与两性霉素B联合使用、两性霉素B单药治疗以及替代药物。本研究表明，美国以外地区的流行病学数据仍然匮乏。血清学检测是日常医疗实践中首选的诊断方法，而培养仍然是金标准。球孢子菌病的治疗药物是酮康唑和两性霉素B，可单独使用或联合使用。
