Acute Pulmonary Coccidioidomycosis-A Case Report

急性肺部球霉菌感染症－病例報告

陳正雄(Cheng-Hsiung Chen) ； 蔡政宏(Cheng-Huag Tsai) ； 葉金水(Chin-Shui Yeh) ； 蕭富源(Fu-Yuan Siao) ； 紀炳銓(Bin-Chuan Ji) ； 蘇子誠(Tzu-Cheng Su) ； 蔡偉宏(Woei-Horng Chai)

《重症醫學雜誌》 12卷3期 (2011/08) Pp. 135-139

https://doi.org/10.30035/TCCM.201108.0007

摘要

球霉菌感染症是由同質二形的粗球霉菌所造成。這種疾病是地方性的好發於美國西南部。球霉菌種生長在土壤內經由空氣傳播的關節頂端芽胞產生肺部感染。大部分球霉菌感染會自己復原經由使用或未使用抗霉菌藥物，嚴重的肺部感染症可能發生特別是免疫功能降低的患者但是很少見，我們報告一個51歲男性患有急性肺部球霉菌感染經由痰液培養及病理組織檢查診斷，他起先主訴有發燒及咳嗽有白色痰液持續七天，之後發展成急性呼吸窘迫症候群及敗血性休克，我們處方Amphotercin B 75 mg每天一次靜脈注射，他的臨床症狀及胸腔X光逐漸改善並於九天後成功拔除氣管內管。

關鍵字

球霉菌感染症 ； 地方性的 ； 急性呼吸窘迫症候群

並列摘要

Coccidioidomycosis (valley fever) is caused by the dimorphic fungus ”Coccidioides immitis”. The disease is endemic to the southwestern United States. Coccidioides species live in the soil and produce pulmonary infection via airborne arthroconidia. Most coccidioidal infections are self-limited and resolve with or without antifungal treatment. Severe pulmonary involvement may occur, especially in immunocompromised patients, but rarely. We presented a 51-year-old man with acute pulmonary coccidioidomycosis diagnosed via sputum culture and histopathological examination. He had fever and productive cough with whitish sputum for 7 days initially, and then developed acute respiratory distress syndrome (ARDS) and septic shock. We prescribed amphotericin B 75 mg once daily by intravenous administration. His clinical condition and chest radiography improved, and gradual, successful extubation was performed 9 days later.

並列關鍵字

Coccidioidomycosis ； endemic ； Acute respiratory distress syndrome (ARDS)