Gurney J W, Conces D J
Department of Radiology, University of Nebraska Medical Center, Omaha, NE 68198-1045, USA.
Radiology. 1996 May;199(2):297-306. doi: 10.1148/radiology.199.2.8668768.
Histoplasmosis is a common infection in the central United States and is acquired through inhalation of airborne spores. The majority of infected persons have an asymptomatic, self-limiting illness. Clinical pneumonia occurs in those with exposure to a large number of infecting spores. Resolution of the pneumonia often leaves calcified pulmonary nodules, calcified mediastinal lymph nodes, or splenic calcifications. Chronic disease, which mimics tuberculosis, may develop in those with underlying emphysema. In patients with deficient cell-mediated immunity, Histoplasma capsulatum may disseminate throughout the body; this often is fatal. Delayed manifestations arise months or years after the primary infection. Broncholithiasis occurs when peribronchial calcific nodes produce bronchial obstruction. Mediastinal granuloma is the continued proliferation of fibrous tissue in draining mediastinal lymph nodes. These granulomas may obstruct adjacent veins, arteries, or airways and lead to various clinical symptoms.
组织胞浆菌病在美国中部是一种常见感染，通过吸入空气中的孢子而获得。大多数感染者患有无症状的自限性疾病。临床肺炎发生在接触大量感染性孢子的人群中。肺炎消退后常留下钙化的肺结节、钙化的纵隔淋巴结或脾脏钙化。模仿结核病的慢性病可能在患有潜在肺气肿的人群中发展。在细胞介导免疫缺陷的患者中，荚膜组织胞浆菌可能扩散至全身；这通常是致命的。延迟表现出现在初次感染数月或数年之后。当支气管周围钙化结节导致支气管阻塞时，会发生支气管结石症。纵隔肉芽肿是引流纵隔淋巴结中纤维组织的持续增生。这些肉芽肿可能阻塞相邻的静脉、动脉或气道，并导致各种临床症状。
