Cockerill F R, Roberts G D, Rosenblatt J E, Utz J P, Utz D C
Chest. 1984 Nov;86(5):688-92. doi: 10.1378/chest.86.5.688.
Epidemics of pulmonary blastomycosis have rarely been reported. The following epidemic occurred in a Minnesota family and several of their acquaintances after a canoeing trip in northwestern Wisconsin. The common exposure area was most likely a campsite, located along the upper reaches of the Namekagon River. The Namekagon River Valley is a known endemic area of Namekagon fever (blastomycosis) in dogs. Approximately one month after returning home, five of the eight members of the group had positive direct microscopic examinations and cultures of Blastomyces dermatitidis from their sputa, as well as abnormalities on their chest roentgenograms. Among these five patients, four were symptomatic, with fever, cough, and pleuritic chest pain. Of the three others, one had pleuritic chest pain with a transient lung infiltrate, the second was asymptomatic with a transient lung infiltrate, and the third was asymptomatic with a normal chest roentgenogram. Results of acute serologic tests (complement fixation and immunodiffusion) were negative in all five patients evaluated. None of the patients received antifungal therapy. Follow-up five years after the epidemic revealed that all eight were in excellent health, and none had evidence of continuing pulmonary or extrapulmonary disease.
肺芽生菌病的流行鲜有报道。以下这起疫情发生在明尼苏达州的一个家庭及其几位熟人身上，他们在威斯康星州西北部进行了一次独木舟旅行之后发病。共同的暴露区域很可能是一个露营地，位于纳梅卡贡河上游。纳梅卡贡河谷是犬类纳梅卡贡热（芽生菌病）的已知流行地区。回家大约一个月后，该旅行团八名成员中的五人痰液直接显微镜检查和皮炎芽生菌培养呈阳性，胸部X线片也有异常。在这五名患者中，四名有症状，表现为发热、咳嗽和胸膜炎性胸痛。另外三人中，一人有胸膜炎性胸痛伴短暂肺部浸润，第二人无症状但有短暂肺部浸润，第三人无症状且胸部X线片正常。所有接受评估的五名患者急性血清学检测（补体结合试验和免疫扩散试验）结果均为阴性。所有患者均未接受抗真菌治疗。疫情发生五年后的随访显示，所有八人健康状况良好，均无持续肺部或肺外疾病的迹象。
