An Outbreak of Histoplasmosis among Healthy Young Japanese Women after Traveling to Southeast Asia
An Outbreak of Histoplasmosis among Healthy Young Japanese Women after Traveling to Southeast Asia
复制标题
DOI：
10.2169/internalmedicine.49.2759
复制
发表时间：
2010-01-01
影响因子：
1.2
通讯作者：
Miyazaki, Yoshitsugu
中科院分区：
文献类型：
--
作者：
Ohno, Hideaki;Ogata, Yoshiko;Miyazaki, Yoshitsugu
组织胞浆菌病是由组织胞浆菌引起的一种地方性真菌病，在世界上除日本外的许多国家都有发生。组织胞浆菌病在日本人中的暴发非常罕见，主要由旅行者输入。我们报告了一起组织胞浆菌病在前往东南亚度假区旅游的健康日本人中的暴发。三名年轻的日本妇女前往马来西亚的兰卡维岛，在岛上呆了五天，没有参观洞穴，洞穴是已知的囊状螺旋藻的蓄水池。这三个人在返回日本大约10天后都出现了流感样症状，胸部X光或胸部CT扫描显示有多个结节阴影。3例患者的血清标本肺活检标本中抗组织胞浆体抗体和包膜螺旋体特异性聚合酶链式反应均为阳性，1例患者血清为阳性。在没有使用抗真菌药物的情况下，所有三名患者的临床病程都有所改善，并且没有复发。临床服务人员在走访包虫病流行区，特别是东南亚地区后，如果看到有流感样症状、胸部X光异常的患者，应考虑组织胞浆菌感染。
Histoplasmosis, caused by Histoplasma capsulatum, is an endemic mycosis in many countries of the world except for Japan. Outbreaks of histoplasmosis among Japanese people are very rare and are mainly imported by travelers. We report an outbreak of histoplasmosis among healthy Japanese people who traveled to a resort area in Southeast Asia. Three young Japanese women traveled to Langkawi island, Malaysia and stayed on the island for five days without visiting caves, a known reservoir of H. capsulatum. All three individuals developed flu-like symptoms with multiple nodule shadows on chest X rays or chest CT scans at around ten days after their return to Japan. Serum samples obtained from the three subjects were positive for anti-Histoplasma antibody and specific PCR for H. capsulatum on lung biopsy specimens and the serum from one patient was positive. The clinical course of all three patients improved without the use of anti-fungal agents and no recurrence has been confirmed. Clinical attendants should consider histoplasmosis when they see patients with flu- like symptoms with abnormal chest X-rays after visiting H. capsulatum endemic areas, especially Southeast Asia.