Rohatgi P K, Schmitt R G
Am J Med Sci. 1984 May-Jun;287(3):27-30. doi: 10.1097/00000441-198405000-00009.
Cavitary pulmonary disease due to coccidioidomycosis is common; however, development of both the underlying cavity and the fungus ball due to Coccidioides immitis is rare and has been reported on only five occasions. We report a case of coccidioidal mycetoma formation as a late sequelae of primary pulmonary coccidioidal pneumonia. Therapy with 2 gm of amphotericin B was unsuccessful and, because of recurrent hemoptysis, the patient required lobar resection. Endosporulating spherules, as well as septate mycelia with arthrospore formation, were found on histologic examination. The medical and surgical management, as well as the potential of such lesions to produce human to human transmission, is discussed.
球孢子菌病引起的空洞性肺部疾病很常见；然而，由粗球孢子菌引起的潜在空洞和真菌球的形成却很罕见，仅在5例病例中有报道。我们报告一例原发性肺球孢子菌病肺炎的晚期后遗症——球孢子菌性足菌肿形成。使用2克两性霉素B治疗未成功，由于反复咯血，患者需要进行肺叶切除。组织学检查发现了内生孢子的球形体以及形成关节孢子的分隔菌丝体。本文讨论了药物和手术治疗方法，以及此类病变产生人际传播的可能性。
