The epidemiology of blastomycosis in Illinois and factors associated with death
The epidemiology of blastomycosis in Illinois and factors associated with death
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DOI：
10.1086/498152
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发表时间：
2005-12-15
影响因子：
11.8
通讯作者：
Huhn, G
中科院分区：
文献类型：
--
作者：
Dworkin, MS;Duckro, AN;Huhn, G
背景。芽生菌病是一种全身性真菌病，可能无症状或进行性，并可能导致死亡。针对伊利诺伊州芽生菌病病例数增加的情况，对1993年1月至2003年8月向伊利诺伊州公共卫生部报告的监测数据进行了分析，并审查了4名死亡患者的医疗记录。结果。在报告的 500 例病例中，患者的中位年龄为 43 岁（范围为 4-87 岁），死亡 34 例（7%）。黑人、65 岁以上和男性的死亡率较高。从发病到诊断的中位时间为 128 天（范围：12-489 天）。死亡与从发病到诊断的时间为 128 天（OR，2.1；95% CI，1.0-4.8）。从 1993 年到 2002 年期间，每年报告的病例数从 24 例增加到 87 例（P < .05）。结论。伊利诺伊州芽生菌病的发病率一直在增加。为了降低与诊断和治疗延误相关的死亡率，医疗人员需要接受有关芽生菌病的教育，重点是症状识别、诊断方法和适当的抗真菌治疗。
Background. Blastomycosis is a systemic fungal disease that may be asymptomatic or progressive and may lead to death.Methods. In response to a reported increase in the number of cases of blastomycosis in Illinois, surveillance data reported to the Illinois Department of Public Health from January 1993 to August 2003 were analyzed and the medical records of 4 patients who died were reviewed.Results. Among the 500 cases reported, the median age of the patients was 43 years (range, 4-87 years), and 34 patients (7%) died. Higher rates of mortality were observed among persons who were black, who were >= 65 years of age, and who were male. The median time from onset of illness to diagnosis was 128 days (range, 12-489 days). Death was associated with a time from onset of illness to diagnosis of 128 days (OR, 2.1; 95% CI, 1.0-4.8). During the period from 1993 through 2002, the number of cases reported per year increased from 24 to 87 (P < .05).Conclusions. The incidence of blastomycosis has been increasing in Illinois. To reduce mortality related to delay in diagnosis and treatment, medical providers need to be educated about blastomycosis, with an emphasis on symptom recognition, methods of diagnosis, and appropriate antifungal treatment.