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Received China Academic Journal ago 10 1 Mouzuo Hua, HE Jue; nine cases misdiagnosed as histoplasmosis of Penicillium marneffei Clinical pathological analysis [J]; Gannan Medical College; 05 2002 Liu Xinmin of 2! 518035, Ninan Sheng! 518035, wild horses! 518035, Tam Hong Kong! 518035, DU New! 518035, Li! 518035, Ronin! 518035; AIDS disease complicated by Penicillium marneffei [J]; Rare and Uncommon Diseases; 2000 02 3 Lu Lin, Hu Xiangren, Wumeng Hua, WANG Hai-ying, Zhang Rongping; Mani Fei six cases of Penicillium disease misdiagnosed [J]; clinical misdiagnosis and mistreatment; 2001 06 4 Ruanmei Juan, Zhu Shan Zhu, Xiu Wang Nan, Wang Jian Ping; resembles lung cancer clinical histoplasmosis analysis [J]; Chinese Clinical Medicine; 2002 Jun 06 5 cover benefits; AIDS combined Penicillium marneffei laboratory features of the disease [J]; of AIDS; 2000 06 6 Dengzhuo Lin! 530021 Nanning, Ma Yun! 530021 Nanning; resembles histoplasmosis of Penicillium marneffei disease [J]; Pathology; 1999 05 7 Deng Zhuolin! 530021 Nanning, Ma Yun ! 530021 Nanning; disease of Penicillium marneffei and histoplasmosis in the differential diagnosis [J]; Laboratory Medicine; 8, 1999, 05 wild horses, Liu Xinmin; AIDS disease complicated by Penicillium marneffei fungal culture and identification [J]; AND HEALTH; 2002 01 9 Li Yun, Wang Huixuan, Xiazheng Wu, Li Xuemei; Penicillium marneffei and Penicillium marneffei disease [J]; of Misdiagnosis; 15, 2005 10 Li Yun, Zhang Yue, Wang Huixuan, Li Xuemei, C


hen Yan; Penicillium laboratory diagnosis [J]; Chinese Medicine; 18, 2005
Disease histoplasmosis Name: histoplasmosis respective areas: the systemic treatment sections: the epidemiology of symptoms and signs: fever, ulcers, cough, hepatomegaly, splenomegaly About histoplasmosis
A histoplasmosis caused by the disease, can cause primary pulmonary lesions and disseminated by the bloodstream. Histoplasmosis histoplasmosis knowledge of the cause: the capsule of the disease caused by histoplasmosis . Phase of the fungi genus in . the symptoms of histoplasmosis: Using sputum, lymph nodes, bone marrow, liver biopsy, blood, urine or oral ulcers points . check histoplasmosis: The disease can not simply make a diagnosis and clinical history. Chest X-ray examination, . histoplasmosis in the differential diagnosis: brown solution layer culture centrifugation or sedimentation can increase the positive rate of blood samples. Was the prevention of histoplasmosis: Solving histoplasmosis is the best way to avoid exposure to infections caused by the horse . the complications of histoplasmosis: Fortunately, with histoplasmosis serious complications related to bacterial disease is very rare . the treatment of histoplasmosis: Although a large number of infected in a very small number of deaths reported, but acute primary . Related articles histoplasmosis
The names of diseases histoplasmosis Classification of Diseases of Dermatology, Infectious Diseases Overof histoplasmosis disease is a primary fungal disease. Mainly in the United States, the Mississippi and Ohio River Valley
Histoplasmosis. Very rare in China, has reported 11 cases of domestic cases. By the capsule of the disease caused by histoplasmosis. The biphasic genus fungi, yeast type in the organization was at room temperature, and soil type were hyphae. Some people think that only the yeast-type disease, and non-pathogenic filamentous form. When people inhale the spores of this fungus, the first cause of primary pulmonary infection, and healthy people often died of self-healing. However, immunocompromised, or defect, such as malignant disease, or with plenty of corticosteroids and immunosuppressive agents, or the inhalation of spores, the formation of lung lesions, disseminated through the lymphatic or blood to the body. Most patients heal without treatment. Severe, to the best effect of amphotericin B, but can also be used fluorocytosine, ketoconazole and clotrimazole and so on. Patients with acute lung type symptoms for 2 weeks, with amphotericin B, total dose of 0.8 ~ 1.0g; lung disease with severe impaired lung function, to prednisone 60 ~ 80mg / d. Disseminated amphotericin B, a course of adult (10 weeks), total 2.0g, graded infusion; children 1mg/kg/d, at least 6 weeks. Chronic lung type, particularly those who are empty, treatment with disseminated; chemotherapy invalid or secondary infection with persistent hemoptysis, or symptoms caused by damage to lung tissue, should be surgically removed. Description histoplasmosis disease is a primary fungal disease. Mainly in the United States, the Mississippi and Ohio River Valley. Very rare in China, has reported 11 cases of domestic cases. Histoplasmosis is a highly infectious fungal disease. Often transmitted by the respiratory tract, the first violation of the lung, and then spto other monocyte-macrophage system, such as the liver, spleen, can also be violations of the kidney, central nervous system and other organs. The disease spthroughout the world, China's first since 1955 in Guangzhou found in 1 case, and subsequently one after another in Changzhou, Beijing, Nanjing and other places that the number of cases. We have found that in 1990 the first case of duboisii variants infected. Symptoms and signs 1, a history of cryptococcosis and pay attention to see whether the early onset of upper respiratory tract infection or flu-like symptoms associated with dry cough, fatigue,
Histoplasmosis weight loss, night sweats, hemoptysis, symptoms similar to tuberculosis, or high fever, shortness of breath symptoms similar to acute pneumonia. 2, medical attention lung signs, with or without hepatosplenomegaly, skin ulcer, or granuloma. According to their clinical manifestations, can be summarized as follows: 1, about 95% of the acute symptoms of primary histoplasmosis can be asymptomatic. Population in endemic areas, lung calcification can be seen in many, but retrospective medical history but no obvious symptoms. 2, the only non-infected patients with mild cough, sputum, chest pain, shortness of breath, hoarseness and other cold symptoms, children often can be expressed as "summer fever"-like symptoms. 3, moderate infections may have fever, night sweats, weight loss, slight cyanosis, hemoptysis between, and sometimes from the patient's sputum and bone marrow cultured pathogen. X ray shows lung field are scattered in most invasive or nodular lesions, hilar lymph nodes like primary pulmonary tuberculosis, severe disseminated is like a lymphoma or other tumors. Disease causes histoplasmosis is a primary fungal disease. Mainly in the United States, the Mississippi and Ohio River Valley. Very rare in China, to the reported 11 cases of domestic cases. By the capsule of the disease caused by histoplasmosis. The biphasic genus fungi, yeast type in the organization was at room temperature, and soil type were hyphae. Some people think that only the yeast-type disease, and non-pathogenic filamentous form. When people inhale the spores of the bacteria after
Histoplasmosis, the first cause of primary pulmonary infection, and healthy people often died of self-healing. However, immunocompromised, or defect, such as malignant disease, or with plenty of corticosteroids and immunosuppressive agents, or the inhalation of spores, the formation of lung lesions, disseminated through the lymphatic or blood to the body. Most patients heal without treatment. Severe, to the best effect of amphotericin B, but can also be used fluorocytosine, ketoconazole and clotrimazole and so on. Patients with acute lung type symptoms for 2 weeks, with amphotericin B, total dose of 0.8 ~ 1.0g; lung disease with severe impaired lung function, to prednisone 60 ~ 80mg / d. Disseminated amphotericin B, a course of adult (10 weeks), total 2.0g, graded infusion; children 1mg/kg/d, at least 6 weeks. Chronic lung type, particularly those who are empty, treatment with disseminated; chemotherapy invalid or secondary infection with persistent hemoptysis, or symptoms caused by damage to lung tissue, should be surgically removed. Pathophysiology of this disease by the respiratory tract, skin and mucous membranes, gastrointestinal tract, such as introduction of infection in endemic areas in patients and animal manure waste can be contaminated, the bacteria sneak in the hen house. When bacteria invade the body, depending on the resistance and was limited to patients with primary or disseminated infection, usually more common in male patients.
Histoplasmosis violated by the bacteria in all organs, consistent with the pathological changes. Started for the central part of the proliferation, phagocytic cells have more or less fungi. Subsequent tissue necrosis occurs, the surrounding granuloma-like changes were, finally, healing or fibrosis. Primary histoplasmosis was non-specific inflammatory infiltration, sometimes seen with giant cells and necrotic areas. Often concurrent clinical manifestations of disseminated disease in the reticuloendothelial system in a critical condition, infants and the elderly are easy to get a significant systemic symptoms such as fever, chills, cough, fatigue, weakness, shortness of breath, chest pain, abdominal pain, headache, weight loss, diarrhea, and sometimes stool. Jihuan different course. More than a liver, spleen and lymph nodes, anemia hypochromic. Leukopenia, lymphocytosis, thrombocytopenia, and so on. Children are like baby severe miliary tuberculosis, such as paleness, weight loss, night sweats, liver, spleen and lymph node enlargement. Some children with skin mucous membrane damage. The Lung caused by inhalation of Histoplasma spores and disease, the sub-acute and chronic. 1. Acute pulmonary histoplasmosis onset hurry, accompanied by general malaise, fever, chills, cough, chest pain, sweating, shortness of breath. However, very few positive signs, chest X ray examination showed scattered nodular pulmonary infiltration shadow or limitations. Basic lesions of primary pulmonary infection is accompanied by granulomatous hilar lesions lymphadenitis. The number of pulmonary granulomatous lesions and inhaled pathogens volume. The acute form is a benign process, most of the mitigation itself, and only 0.1% ~ 0.2% chance of developing into a systemic disease. Chronic pulmonary histoplasmosis is very similar clinical manifestations of chronic pulmonary tuberculosis, such as cough, chest pain, fever, chills, dyspnea, hemoptysis, weakness, fatigue, night sweats, weight loss, can help diagnosis by immunological experiment, check sputum fungi are found can be confirmed. 2. Course of the disease is slow, a few years later, the lungs may have progressive, degenerative disease, duration of up to 1 to 10 years or so, the type of primary lung lesions may be caused by the sp, but also for double infection. Any age may be sick, but infants and children under the age of two most common. High fatality. Skin type more common in adults, skin lesions to the face and neck as much, but can spto the mouth, nose, throat, male external genitalia and limbs, etc., expressed as ulcers, granuloma, nodules, abscesses or necrotic papules, etc. significantly enlarged lymph node, and liquefaction necrosis. Usually no systemic symptoms. Differential diagnosis of children with clinical manifestations resembling tuberculosis, blood diseases, or to be uncritical. Required for fungal examination confirmed the diagnosis: bone marrow smear
Histoplasmosis seen an increase in macrophages, and in some macrophages containing oval yeast-like spores. fungal culture: the bone marrow, tumor tissue or blood inoculated in blood agar plates or Sabouraud medium, after 2 to 4 days later, a white fungal colonies, microscopic examination shows large conidia. Histoplasma skin test streptozotocin often helpful in the diagnosis, especially in those patients with longer, if the skin test is still negative at this time, more than the disease can be. However, in highly endemic areas, if the skin test positive, yet to be confirmed with other indicators. serological tests are diagnostic, especially the elevated titer often help to determine prognosis. Serological tests should be carried out before the skin test, the latter so as to avoid false positive caused by the phenomenon of excitation. Check the test 1, test smear staining, culture and histopathological examination fungi. The serum latex particle agglutination test for the early acute infection. complement fixation test for the diagnosis and prognosis of patients with disseminated valuable. fluorescent antibody test specimens and tissue sections in the identification of pathogens has value. 2, chest X-ray examination if necessary, to do abdominal X-ray and abdominal B-observed in lung, liver, spleen and other organs may have a lot of calcification. Mediastinal histoplasmosis include mediastinal granuloma and fibrosing mediastinitis. Mediastinal granuloma, which is equivalent enveloped mediastinal caseous lymph nodes or fibrosis of the tumor, the moderate performance of mediastinal histoplasmosis. The performance of light can no obvious clinical symptoms of enlarged lymph nodes, and might have fibrosing mediastinitis. In CT, the visible boundary of a clear low-density mass, usually located in the right paratracheal and subcarinal area, may be with or without adjacent structures of oppression. If the fibrosis, mainly, but also calcification. The disease can not simply make a diagnosis and clinical history of chest X-ray examination, computer tomography has diagnostic value. Serological test was positive for diagnosis to help determine mycelial antigen was 1:4 and the yeast antigen was 1:16, is strong evidence of disease activity. Histoplasma skin test-positive Streptomyces, said in the past or present infection for the census. Agar gel diffusion test phase complement fixation test is more than
Histoplasmosis have specific, but with blastomycosis and coccidioidomycosis cross reaction must also be streptozotocin Histoplasma, Blastomyces and Coccidioides streptozotocin streptozotocin skin test for identification. Sputum urine, blood, bone marrow smear or pleural fluid and other secretions of cultured bacteria isolated from histoplasmin, or histopathological type of yeast fungus that can be diagnosed with bronchoscopy biopsy and lavage have confirmed the value of material culture, but also for in the nodules are not calcified, and cavitary lesions. Superficial lymph node biopsy of liver, spleen, lung biopsy for diagnosis of visceral puncture is important but should be careful. Fortunately, complications and related histoplasmosis is a rare serious complications. These complications include: 1 in the lung lining parietal formation of fibrous tissue, squeezing the esophagus, heart or lung affect their function properly. 2 lymph nodes, squeezing the trachea, esophagus or chest of the large vessels 3 to scarring of lung tissue. 4, blind, and if the infection sps to the eyes, the treatment may occur to prevent amphotericin B, ketoconazole, 5 - fluorocytosine and so have a good effect. General supportive therapy is important, such as better nutrition, a nutritious diet and adequate vitamin B and C, if necessary, transfusion, blood transfusion or blood plasma and so on. Drugs such as amphotericin B, amphotericin Lushan, the ball erythromycin. Limitations of the limitations of the skin or lung lesions who can solve the surgical removal of histoplasmosis is the best way to avoid exposure to infections caused by Penicillium marneffei in the following steps to help prevent infection: when you are exposed to soil infected birds or bats to wear masks or respirators when spraying contaminated areas formalin 3% (which will kill fungi), a drug safety, avoid with animal and bird droppings may contain dust. Work in dusty places, you can wear a mask or fungal spores in the area may have sprinklers. 2, 3% of the contaminated areas formalin spray (kills fungi).


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