COCCIDIOIDOMYCOSIS IN POTENTIALLY COMPROMISED HOSTS - EFFECT OF IMMUNOSUPPRESSIVE THERAPY IN DISSEMINATION
COCCIDIOIDOMYCOSIS IN POTENTIALLY COMPROMISED HOSTS - EFFECT OF IMMUNOSUPPRESSIVE THERAPY IN DISSEMINATION
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DOI：
10.1097/00000441-197805000-00006
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发表时间：
1978-01-01
影响因子：
3.1
通讯作者：
SMITH, JW
中科院分区：
文献类型：
--
作者：
RUTALA, PJ;SMITH, JW
对126例球孢子菌病患者的病历进行了回顾。其中16例患者患有恶性肿瘤、尿毒症或胶原血管疾病和/或近期接受过免疫抑制药物治疗。本组播散性感染率为50%。(The 110例对照组患者的播散率为14%。仅患有上述基础疾病的患者中未发生播散病例;所有播散病例均发生在接受免疫抑制治疗的患者中。40岁或以上的对照患者的传播率高于年轻患者。然而，在接受免疫抑制药物治疗的患者中，播散率没有显示出与年龄相关的差异。两种性别的对照患者的传播率相似，免疫抑制治疗的男性和女性的传播率均较高。如果患者接受了免疫抑制药物，则传播率似乎不受循环淋巴细胞数量的影响。接受免疫抑制药物治疗的播散性疾病患者能够对高滴度的球虫微生物产生血清学反应，但无阳性皮试反应。播散性球孢子菌病在免疫抑制的宿主中并不是一律致命的：我们的一半患者在诊断后平均存活33个月。
Charts of 126 patients with coccidioidomycosis were reviewed. Sixteen of these were patients who had malignancies, uremia, or a collagen-vascular disease and/or had received recent immunosuppressive drug therapy. The rate of disseminated infection was 50% in this group.(The dissemination rate was 14% in 110 control patients.) No case of dissemination occurred in patients who only had the above underlying diseases; all cases of dissemination were among those who had received immunosuppressive therapy. The dissemination rate in control patients was higher for patients age 40 or over than for younger patients. The dissemination rate showed no age-related difference, however, in patients treated with immunosuppressive drugs. The dissemination rate was similar in control patients of both sexes and uniformly higher for both immunosuppressively treated males and females. The dissemination rate did not appear to be influenced by the number of circulating lymphocytes if the patient had received immunosuppressive drugs. Patients with disseminated disease who had received immunosuppressive drugs were capable of producing a serological response to the coccidoiidal organism in high titer but none had positive skin test reactivity. Disseminated coccidioidomycosis is not uniformly fatal in the immunosuppressed host: half of our patients are alive an average of 33 months after diagnosis.