McAdams H P, Rosado-de-Christenson M L, Lesar M, Templeton P A, Moran C A
Department of Radiology, Walter Reed Army Medical Center, Washington, DC, USA.
Radiographics. 1995 Mar;15(2):255-70. doi: 10.1148/radiographics.15.2.7761632.
The endemic fungi Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides immitis are primary human pathogens whose major portal of entry is the respiratory tract. Their clinical manifestations are categorized as acute, chronic or chronic progressive, or disseminated fungal disease. Most acute pulmonary infections are self-limited, and many are asymptomatic. Chronic, progressive, or disseminated disease is much less common and most often occurs in immunocompromised patients. The radiologic manifestations of these disorders are protean. They include interstitial or air-space opacities, solitary or multiple pulmonary nodules, parenchymal masses, cavities, and hilar or mediastinal adenopathy. The diagnosis of a thoracic mycosis requires familiarity with the epidemiology of the fungus in question, the various modes of clinical presentation, and the full spectrum of radiologic manifestations. Although skin and serologic tests can be useful, definitive diagnosis requires culture of the fungus from infected tissue or demonstration of the organism at microscopic examination.
地方性真菌荚膜组织胞浆菌、皮炎芽生菌和粗球孢子菌是主要的人类病原体，其主要入侵途径是呼吸道。它们的临床表现分为急性、慢性或慢性进行性，或播散性真菌病。大多数急性肺部感染是自限性的，许多是无症状的。慢性、进行性或播散性疾病则少见得多，且最常发生于免疫功能低下的患者。这些疾病的放射学表现多种多样。包括间质或气腔模糊影、单发或多发肺结节、实质肿块、空洞以及肺门或纵隔淋巴结肿大。诊断胸内真菌病需要熟悉相关真菌的流行病学、各种临床表现方式以及放射学表现的全貌。虽然皮肤和血清学检查可能有用，但确诊需要从感染组织中培养出真菌或在显微镜检查中发现该生物体。
