Kataria Y P, Campbell P B, Burlingham B T
South Med J. 1981 May;74(5):534-7, 542. doi: 10.1097/00007611-198105000-00007.
Three patients with acute pulmonary histoplasmosis presented with extensive, diffuse bilateral infiltrates on chest roentgenograms. Fungal elements were seen in the bronchial secretions of two patients; Histoplasma capsulatum was grown from the third patient and from soil from the patients' workplace. Two patients were severely hypoxemic and required short courses of amphotericin B therapy; in one of these two, progressive deterioration dictated corticosteroid therapy as well, with a dramatic clinical response. Radiologic resolution of disease occurred more quickly in the treated patients. Initial pulmonary function tests suggested mild restriction in each, with normal test results by the fourth month of follow-up. Our experience suggests that amphotericin B may shorten the course of acute histoplasmosis and that corticosteroid therapy may be efficacious in controlling the symptoms related to hyperresponsiveness in fulminant primary disease.
三名急性肺组织胞浆菌病患者胸部X线片显示广泛、弥漫性双侧浸润。在两名患者的支气管分泌物中发现真菌成分；从第三名患者及其工作场所的土壤中培养出荚膜组织胞浆菌。两名患者严重低氧血症，需要短期两性霉素B治疗；在这两名患者中的一名中，病情逐渐恶化，因此也采用了皮质类固醇治疗，临床反应显著。接受治疗的患者疾病的放射学消退更快。最初的肺功能测试表明每名患者均有轻度受限，随访至第四个月时测试结果正常。我们的经验表明，两性霉素B可能会缩短急性组织胞浆菌病的病程，皮质类固醇治疗可能有效控制暴发性原发性疾病中与高反应性相关的症状。
