Bi Huanhuan, Hou Feng, Han Weizhong, Sun JiaXing, Ren DunQiang, Zhuang Min, Zhang Chunling, Wang Hongmei
Department of Respiratory and Critical Care Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266001, China.
Department of Respiratory and Critical Care Medicine, Qingdao Central Hospital, Qingdao 266001, China.
IDCases. 2024 Oct 18;38:e02102. doi: 10.1016/j.idcr.2024.e02102. eCollection 2024.
Coccidioidomycosis is a fungal infection commonly found in the tropical regions of southwestern United States, such as Arizona, the Central Valley of California, parts of New Mexico, and western Texas. The endemic regions also extend into northern Mexico and include focal endemic areas in sections of Central America and Argentina. Coccidioides species have also been reported in central and southern Utah, Nevada, and the central part of Washington State., the pathogenic bacteria commonly colonize the lungs. China, which is outside the traditionally established endemic area, is witnessing a rise in reported cases of pulmonary coccidioidomycosis. Meanwhile, the comorbidities of the disease began to become complicated. We reported two Chinese patients with pulmonary coccidioidomycosis complicated by organizing pneumonia and reviewed 42 cases of Chinese patients in the literature from 1958 to 2024. Out of the 44 patients from 13 different provinces (Including Hong Kong Special Administrative Region and Taiwan), the average age was (43.08 ± 3.03) years. Among them, 34 (76.7 %) were male, while 10 (23.3 %) were female, cough/sputum (81.8 %) are the most common symptoms, the cases are concentrated in coastal areas. 27(61.4 %) were Imported and 17(38.6 %) were domestic primary cases, showing a higher proportion of imported cases compared to domestic primary cases. Misdiagnosis and mistreatment have a significant impact on patients, the combination of new technologies and traditional pathology diagnosis have substantially promoted precise diagnosis for clinician in non-endemic areas. Interestingly, the histopathological findings of the two patients we report showed evident organizing pneumonia and an increased eosinophil count, the application of corticosteroid drugs notably improved the patients' conditions. Overall, at least 84.1 % of patients had a favorable prognosis. Considering the changing epidemiology of pulmonary coccidioidomycosis, Chinese healthcare providers should be cautious about their patients' travel history, particularly among male individuals.
球孢子菌病是一种真菌感染，常见于美国西南部的热带地区，如亚利桑那州、加利福尼亚中央谷地、新墨西哥州部分地区和得克萨斯州西部。流行地区还延伸至墨西哥北部，并包括中美洲和阿根廷部分地区的局部流行区。犹他州中部和南部、内华达州以及华盛顿州中部也报告发现了球孢子菌属。这种致病细菌通常在肺部定植。中国不在传统的流行区域内，但报告的肺球孢子菌病病例正在增加。与此同时，该疾病的合并症开始变得复杂。我们报告了两名合并机化性肺炎的中国肺球孢子菌病患者，并回顾了1958年至2024年文献中42例中国患者的情况。在来自13个不同省份（包括香港特别行政区和台湾）的44名患者中，平均年龄为（43.08±3.03）岁。其中，男性34名（76.7%），女性10名（23.3%），咳嗽/咳痰（81.8%）是最常见的症状，病例集中在沿海地区。27例（61.4%）为输入性病例，17例（38.6%）为国内原发性病例，输入性病例比例高于国内原发性病例。误诊和误治对患者有重大影响，新技术与传统病理诊断相结合极大地促进了非流行地区临床医生的精准诊断。有趣的是，我们报告的两名患者的组织病理学结果显示有明显的机化性肺炎且嗜酸性粒细胞计数增加，应用皮质类固醇药物显著改善了患者的病情。总体而言，至少84.1%的患者预后良好。考虑到肺球孢子菌病不断变化的流行病学情况，中国医疗服务提供者应谨慎询问患者的旅行史，尤其是男性患者。
