Abstract：
OBJECTIVE: Coccidioidomycosis, caused by the Coccidioides species, is a well-known disease in the Southwestern United States and North Mexico, with scattered reports in Latin America countries. While this disease is still rare in Japan and other Asian countries, its incidence has been increasing over the last two decades. Coccidioides species are highly infectious and require caution when encountered. This study presents a case series of chronic pulmonary coccidioidomycosis surgically treated at a single institution.
METHODS: We conducted a retrospective chart review of six patients who underwent lung resection for pulmonary coccidioidomycosis at Chiba University Hospital between January 2007 and December 2021.
RESULTS: All six patients had travelled to the Southwestern United States. Preoperative serology was negative for the anti-Coccidioides antibody in four patients and positive in two. Chest computed tomography revealed a single, well-defined round nodule in all patients. Preoperative biopsy taken from three patients failed to obtain a definitive diagnosis. Histopathological examination of the resected pulmonary nodules revealed granulomas that contained numerous spherules with many endospores, thereby confirming the diagnosis of pulmonary coccidioidomycosis.
CONCLUSIONS: Pulmonary coccidioidomycosis should be suspected based on travel history and radiological findings. Meticulous care should be taken during specimen processing to prevent cross infection.
METHODS: We conducted a retrospective chart review of six patients who underwent lung resection for pulmonary coccidioidomycosis at Chiba University Hospital between January 2007 and December 2021.
RESULTS: All six patients had travelled to the Southwestern United States. Preoperative serology was negative for the anti-Coccidioides antibody in four patients and positive in two. Chest computed tomography revealed a single, well-defined round nodule in all patients. Preoperative biopsy taken from three patients failed to obtain a definitive diagnosis. Histopathological examination of the resected pulmonary nodules revealed granulomas that contained numerous spherules with many endospores, thereby confirming the diagnosis of pulmonary coccidioidomycosis.
CONCLUSIONS: Pulmonary coccidioidomycosis should be suspected based on travel history and radiological findings. Meticulous care should be taken during specimen processing to prevent cross infection.
摘要：
目标：球孢子菌病，由球虫物种引起的，是美国西南部和墨西哥北部的一种众所周知的疾病，在拉丁美洲国家有分散的报道。虽然这种疾病在日本和其他亚洲国家仍然很少见，在过去的二十年里，它的发病率一直在增加。球虫物种具有高度传染性，遇到时需要谨慎。这项研究介绍了在单一机构手术治疗的一系列慢性肺球孢子菌病。
方法：我们对2007年1月至2021年12月在千叶大学医院接受肺包虫菌病肺切除术的6例患者进行了回顾性分析。
结果：所有6名患者都曾前往美国西南部。4例患者的术前血清学抗球虫抗体阴性，2例阳性。胸部计算机断层扫描显示，所有患者均有明确的圆形结节。对三名患者进行的术前活检未能获得明确的诊断。切除的肺结节的组织病理学检查显示肉芽肿包含许多球粒和许多内生孢子，从而确认肺球孢子菌病的诊断。
结论：应根据旅行史和影像学检查结果怀疑肺球孢子菌病。标本处理过程中应注意防止交叉感染。
方法：我们对2007年1月至2021年12月在千叶大学医院接受肺包虫菌病肺切除术的6例患者进行了回顾性分析。
结果：所有6名患者都曾前往美国西南部。4例患者的术前血清学抗球虫抗体阴性，2例阳性。胸部计算机断层扫描显示，所有患者均有明确的圆形结节。对三名患者进行的术前活检未能获得明确的诊断。切除的肺结节的组织病理学检查显示肉芽肿包含许多球粒和许多内生孢子，从而确认肺球孢子菌病的诊断。
结论：应根据旅行史和影像学检查结果怀疑肺球孢子菌病。标本处理过程中应注意防止交叉感染。
