Manns B J, Baylis B W, Urbanski S J, Gibb A P, Rabin H R
Department of Internal Medicine, Foothills Medical Center, Alberta, Canada.
Clin Infect Dis. 1996 Nov;23(5):1026-32. doi: 10.1093/clinids/23.5.1026.
A previously well 59-year-old man presented with paracoccidioidomycosis, more than 15 years after leaving South America. He failed to respond to conventional therapies, first with oral itraconazole and then with amphotericin B plus sulfadiazine, and eventually died of recurrent arterial emboli possibly due to paracoccidioidomycotic aortitis. This patient's presentation demonstrates the difficulties that may be encountered in diagnosing and managing this disease. Paracoccidioidomycosis should be suspected in patients with an appropriate travel history who experience weight loss and have pulmonary, mucosal, and cutaneous lesions. This article comprehensively reviews the literature, with emphasis on epidemiology, clinical presentation, diagnosis, and therapy with imidazole antifungal medications.
一名既往健康的59岁男性在离开南美洲15年多后出现副球孢子菌病。他对传统治疗无效，先是口服伊曲康唑，后是两性霉素B加磺胺嘧啶，最终死于可能由副球孢子菌性主动脉炎引起的反复动脉栓塞。该患者的病例显示了诊断和管理这种疾病可能遇到的困难。对于有适当旅行史、体重减轻且有肺部、黏膜和皮肤病变的患者，应怀疑患有副球孢子菌病。本文全面回顾了文献，重点关注流行病学、临床表现、诊断以及咪唑类抗真菌药物的治疗。
