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Coccidioidomycosis

  • Обзор
  • Теория
  • Диагноз
  • Лечение
  • Последующее наблюдение
  • Источники
Последний просмотренный: 3 Oct 2026
Last updated: 08 Apr 2026

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • asymptomatic
  • fever
  • cough
  • rash
Полная информация

Другие диагностические факторы

  • headache
  • fatigue
  • pleuritic chest pain
  • dyspnea
  • myalgia or arthralgia
  • weight loss
  • night sweats
  • chills
  • rales, rhonchi, wheeze, or rub
  • bronchial breathing
  • hemoptysis
  • pyopneumothorax
  • lymphadenopathy
  • abnormal mental status or neurologic exam
Полная информация

Факторы риска

  • immunosuppression, especially suppression of cell-mediated immunity
  • occupation involving digging or construction
  • recreational activities that increase likelihood of dust inhalation
  • extremes of age
  • male sex
  • residing in or visiting endemic areas
  • African-American or Filipino ancestry
  • blood group B
  • pregnancy
  • HLA groups
  • diabetes mellitus
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • sputum culture
  • enzyme immunoassay serology for coccidioidomycosis
  • immunodiffusion serology for coccidioidomycosis
  • complement fixation serology for coccidioidomycosis
  • CBC
  • chest x-ray
Полная информация

Исследования, проведение которых нужно рассмотреть

  • antigen testing
  • polymerase chain reaction (PCR)
  • lung biopsy
  • lumbar puncture
  • erythrocyte sedimentation rate
  • CT chest
  • bone scan
  • MRI
Полная информация

Неотложные исследования

  • lateral flow assay (LFA)

Алгоритм лечения

Острый

mild to moderate coccidioidal pneumonia (nonpregnant; without HIV)

mild to moderate coccidioidal pneumonia (nonpregnant; with HIV)

severe or diffuse coccidioidal pneumonia (nonpregnant; without HIV)

severe or diffuse coccidioidal pneumonia (nonpregnant; with HIV)

pulmonary nodule (nonpregnant)

asymptomatic pulmonary cavity (nonpregnant)

symptomatic pulmonary cavity (nonpregnant)

chronic progressive fibrocavitary coccidioidomycosis (nonpregnant)

skin and soft tissue coccidioidomycosis (nonpregnant)

skeletal coccidioidomycosis (nonpregnant)

coccidioidal meningitis (nonpregnant)

pregnant

Составители

Авторы

Janis E. Blair, MD

Professor of Medicine

Mayo Clinic College of Medicine and Sciences

Rochester

MN

Division of Infectious Diseases

Mayo Clinic

Phoenix

AZ

Раскрытие информации

JEB declares that she has no competing interests.

Рецензенты

Susan Hoover, MD

Infectious Diseases Clinic

Sanford Health Sioux Falls

SD

Раскрытие информации

SH declares that she has no competing interests.

Astrid Mayr, MD

Professor of Medicine

Department of Hygiene and Medical Microbiology

Medical University Innsbruck

Innsbruck

Austria

Раскрытие информации

AM declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Thompson GR 3rd, Le T, Chindamporn A, et al. Global guideline for the diagnosis and management of the endemic mycoses: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology. Lancet Infect Dis. 2021 Dec;21(12):e364-74. Аннотация

Galgiani JN, Ampel NM, Blair JE, et al. 2016 Infectious Diseases Society of America (IDSA) clinical practice guideline for the treatment of coccidioidomycosis. Clin Infect Dis. 2016 Sep 15;63(6):e112-46.Полный текст  Аннотация

National Institutes of Health, Centers for Disease Control and Prevention, HIV Medicine Association, and Infectious Diseases Society of America. Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV. Jul 2025 [internet publication].Полный текст

Hage CA, Carmona EM, Epelbaum O, et al. Microbiological laboratory testing in the diagnosis of fungal infections in pulmonary and critical care practice. An official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 2019 Sep 1;200(5):535-50.Полный текст  Аннотация

Limper AH, Knox KS, Sarosi GA, et al; American Thoracic Society Fungal Working Group. An official American Thoracic Society statement: treatment of fungal infections in adult pulmonary and critical care patients. Am J Respir Crit Care Med. 2011 Jan 1;183(1):96-128.Полный текст  Аннотация

Статьи, указанные как источники

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