coccidioidomycosis скачать в хорошем качестве

coccidioidomycosis

(Valley fever, desert rheumatism, California fever) A mammalian fungal disease caused by Coccidioides immitis or Coccidioides posadasii. It is endemic in certain parts of the United States in Arizona, California, Nevada, New Mexico, Texas, Utah, and northern Mexico. It is a common cause of community-acquired pneumonia. It is not contagious. In some cases the infection may recur or become chronic. Infections usually occur due to inhalation of the airborne arthroconidia (spores) after soil disruption. Arthroconidia are a type of fungal spore typically produced by segmentation of pre-existing fungal hyphae. (Types) • acute: Described as primary pulmonary coccidioidomycosis. • chronic • disseminated: Includes primary cutaneous coccidioidomycosis. (Symptoms) Minimal to no symptoms. Clinical symptoms: • respiratory symptoms: Most common. Resemble bronchitis or pneumonia. It may last for a few weeks. • profound feeling of tiredness: It can persist for many months. • loss of smell and taste • fever • cough • headaches • rash • muscle pain • joint pain (Classic triad) • fever • joint pains • erythema nodosum (Complications) Some patients who have weakened immune systems do not recover from the initial acute infection and develop a chronic infection, resulting in chronic lung infection or widespread disseminated infection (affecting the tissues lining the brain, soft tissues, joints, and bone). • chronic fibrocavitary disease: Manifested by cough (sometimes productive of mucus), fevers, night sweats, and weight loss. • osteomyelitis (including involvement of the spine): May occur months to years after initial infection. • meningitis: May occur months to years after initial infection. • severe lung disease: May develop in HIV patients. (Diagnosis) • symptoms • radiographic imaging (chest X-rays, computed tomography (CT) scans of the chest) • laboratory tests - microscopic examination using diagnostic cells in body fluids, exudates, sputum and biopsy tissue by Papanicolaou stain or Grocott's methenamine silver staining. - culture by morphological identification - fungal antigen or host IgM or IgG antibody produced against the fungus: Tested by tube-precipitin (TP) assays, complement fixation assays, and enzyme immunoassays (ELISA). - DNA amplified by polymerase chain reaction (PCR) (Treatment) • intravenous amphotericin B: Itraconazole and ketoconazole for milder disease as alternatives. • oral fluconazole: For coccidioidal meningitis, due to its penetration into the cerebrospinal fluid (CSF). If infection persists, intrathecal or intraventricular amphotericin B therapy. • itraconazole: For bones and joints. • posaconazole: Also treats invasive aspergillosis, candidiasis, etc. • voriconazole: Also treats aspergillosis, candidiasis, histoplasmosis, penicilliosis, and infections by Scedosporium or Fusarium.