Swartz M A, Scofield R H, Dickey W D, Kirk J L, Wilson D A, Pitha J V, Muchmore H G
Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
Clin Infect Dis. 1996 Oct;23(4):813-5. doi: 10.1093/clinids/23.4.813.
Human infection with Histoplasma capsulatum runs the gamut from asymptomatic to disseminated disease. CT-directed fine-needle aspiration of bilaterally enlarged adrenal glands has been used in diagnosing serious infections with this ubiquitous organism. Three cases have previously been reported in which H. capsulatum infection caused unilateral adrenal enlargement; this enlargement was diagnosed post-mortem. We describe three patients with unilateral adrenal enlargement due to H. capsulatum whose conditions were diagnosed antemortem. We encourage clinicians to include infection with H. capsulatum as well as other granulomatous diseases and tumors in the differential diagnosis of unilateral adrenal enlargement.
人类感染荚膜组织胞浆菌后，病情表现范围广泛，从无症状感染到播散性疾病。CT引导下对双侧肿大肾上腺进行细针穿刺抽吸已用于诊断这种普遍存在的生物体引起的严重感染。此前曾报告过3例荚膜组织胞浆菌感染导致单侧肾上腺肿大的病例，这种肿大是在尸检时确诊的。我们描述了3例因荚膜组织胞浆菌感染导致单侧肾上腺肿大且在生前确诊的患者。我们鼓励临床医生在单侧肾上腺肿大的鉴别诊断中考虑荚膜组织胞浆菌感染以及其他肉芽肿性疾病和肿瘤。
