球孢子菌病1例及文献复习  

Report of one case of coccidioidomycosis with literature review

作　　者：潘天宇 刘宏炜 沈梅丽 李永怀[3] 吴通恒 PAN Tianyu;LIU Hongwei;SHEN Meili;LI Yonghuai;WU Tongheng(Shanghai Fengxian Hospital,Shanghai 201400,China;Nanjing Dinfectome Technology Incrporated;Anhui Public Health Clinical Center(The First Affiliated Hospital of Anhui Medical University North District);The First Affiliated Hospital of Anhui Medical University)

机构地区：[1]上海市奉贤区中心医院,上海201400 [2]迪飞医学科技(南京)有限公司 [3]安徽省公共卫生临床中心(安徽医科大学第一附属医院北区) [4]安徽医科大学第一附属医院

出　　处：《热带病与寄生虫学》2024年第2期122-128,共7页Journal of Tropical Diseases and Parasitology

摘　　要：本文报道了1例由波萨达斯球孢子菌感染导致的球孢子菌病病例。患者因发热、咳嗽、咳痰入院,头面部及全身皮肤可见皮疹,内有脓液。实验室检查显示白细胞计数14.25×10^(9)/L,嗜酸性粒细胞绝对值2.64×10^(9)/L,超敏C反应蛋白85.9 mg/L。胸部CT示右肺下叶结节影,纵隔多发肿大淋巴结。予抗感染、对症治疗后,症状未好转。随后提取皮肤组织、脓包脓液和外周静脉血进行宏基因组二代测序,确诊为播散性球孢子菌病,给予抗真菌治疗后明显好转。本文对该病例资料进行回顾性分析并检索相关文献,探讨该病的临床特点、诊断依据及治疗措施,总结诊疗经验,以提高临床工作者对球孢子菌病的认知。This paper reports a case of coccidioidomycosis caused by Coccidioides posadasii.The patient was admitted due to fever,cough and phlegm,skin rash visible on the head,face and body with pus inside.Laboratory tests presented white blood cell count of 14.25×10^(9)/L,an absolute value of 2.64×10^(9)/L for eosinophils,and 85.9 mg/L for hypersensitive C-reactive protein.Chest CT exposed a nodular shadow in the lower lobe of the right lung,with multiple enlarged lymph nodes in the mediastinum.The symptoms were not relieved after anti-infection and symptomatic medication.Metagenomics next-generation sequencing(mNGS)was performed on the skin tissue,purulent pus,and peripheral venous blood.The diagnosis of mNGS was confirmed as disseminated coccidioidomycosis,and the symptom was significantly improved after antifungal treatment.This article retrospectively analyzed the case data and searched for relevant literatures to investigate the clinical characteristics,diagnostic evidences,and treatment measures for this disease,with the diagnosis and treatment experience summarized to improve the understanding of coccidioidomycosis for clinical workers.

关 键 词：波萨达斯球孢子菌 球孢子菌病 宏基因组二代测序 

分 类 号：R519.8[医药卫生—内科学]