Clinical and roentgenographic manifestations of acute and chronic blastomycosis.
Clinical and roentgenographic manifestations of acute and chronic blastomycosis.
复制标题
急性和慢性芽生菌病的临床和X线表现。
DOI：
10.1378/chest.69.3.345
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发表时间：
1976
期刊：
影响因子：
9.6
通讯作者：
Ronald B. George
中科院分区：
文献类型：
--
作者：
Raymond Cush;Richard W. Light;Ronald B. George
对50例经培养证实的芽生菌病患者的X线片和医院记录进行了分析，以确定急性和慢性疾病之间可能存在的差异。6例患者在住院前3周或更短时间内出现急性芽生菌病症状。其余44名患者患有慢性疾病，症状发生长达6年（平均持续时间，住院前10个月）。急性疾病的特点是中毒症状，胸痛，没有可见的积液，肺型实变的胸部电影，和一个相对良性的过程。慢性疾病的毒性较轻，但播散发生率高，伴有胸膜反应、肝脾肿大、皮肤和骨骼受累。46例患者中有36例的痰培养物为皮肤芽生菌阳性;然而，经常需要几份标本来证明湿制剂上的微生物。胸膜液和皮肤病变的物质也可能是真菌的来源。皮肤试验和血清学研究在大多数急性或慢性疾病病例中没有帮助。
Roentgenograms and hospital records of 50 patients with blastomycosis proven by cultures were analyzed to determine possible differences between the acute and chronic forms of the illness. Six patients had acute blastomycosis with symptoms occurring three weeks or less prior to hospitalization. The remaining 44 patients had chronic illnesses with symptoms occurring up to six years (mean duration, ten months before hospitalization). The acute illness was characterized by toxic symptoms, chest pain without visible effusions, pneumonic-type consolidations on the chest films, and a relatively benign course. The chronic illness had less severe toxicity, but a high incidence of dissemination, with pleural reactions, hepatosplenomegaly, and cutaneous and osseous involvement. Sputum cultures were positive for Blastomyces dermatitidis in 36 of 46 patients; however, several specimens were frequently required for demonstration of the organism on wet preparations. Pleural fluid and material from skin lesions were also likely sources of the fungus. Skin tests and serologic studies were not helpful in most cases of either the acute or chronic form of the disease.