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coccidioidomycosis symptoms, early symptoms and signs of coccidioidomycosis

coccidioidomycosis symptoms, early symptoms and signs of coccidioidomycosis

Coccidioidomycosis symptoms

Early symptoms: The skin lesions usually develop chancre-like lesions within 1 to 3 weeks of infection, and later form nodules, which are distributed along the lymphatic vessels, resembling sporotrichosis, lymphangitis and lymphadenopathy, and most of them can heal by themselves.

Late symptoms: Secondary skin lesions usually occur in the nose, cheeks, and scalp. They are manifested as multiple painless nodules with ulceration in the center and occasional wart-like hyperplasia.

Related symptoms: Low-grade fever, enlarged lymph nodes, increased neutrophils, cough with chest pain, increased eosinophils

1. Symptoms:

From the culture of infected body fluids or tissue specimens, or direct examination of exudates in sputum, pleural fluid, cerebrospinal fluid, and draining sinus lesions, or in tissue biopsy specimens stained with silver or PAS, Coccidioidomyces vulgaris is detected Diameter of the intact sphere is usually 20~80μm, thick wall, full of small endospores (diameter 2~4μm). The endospores released from the broken sphere and entering the tissue can be mistaken for Sprouting yeast.

The complement fixation test is still the most useful test for detecting anti-coccidioid IgG antibodies. Serum titer ≥ 1:4 indicates that there is a current infection or a recent infection, and a higher titer (≥ 1:32) indicates that the lung is very likely to have occurred. However, immunosuppressed patients may have a low titer. Successful treatment should decrease the titer. The presence of complement-fixed antibodies in the cerebrospinal fluid can confirm the diagnosis of coccidioid meningitis. This is very important because only a few cases can be diagnosed. Was culture positive.

Other antibody tests, including newer, more sensitive and specific immunological tests, cannot judge the prognosis, and are of little use. People with normal immune function usually develop skin caused by coccidiodin or microsporin within 10 to 21 days after infection. Late-onset allergies, but progressive diseases are characteristically lacking this response. Since the test is positive in most people in endemic areas, it is mainly used for epidemiological research rather than diagnosis.

Clinical features:

a. The incidence is mostly young and middle-aged and field workers, with more men than women.

b. The disease is caused by the infection of Coccidioidomyces vulgaris.

c. Primary skin lesions usually develop chancre-like damage within 1 to 3 weeks of vaccination and infection, and later form nodules, which are distributed along the lymphatic vessels, resembling sporotrichosis, lymphangitis and lymphadenopathy, and most of them can heal spontaneously .

d. Secondary skin lesions often occur in the nose, cheeks, and scalp. They are manifested as multiple painless nodules, ruptured in the center, and occasionally show wart-like hyperplasia.

e. Mucosa and all organs of the whole body can be affected, but muscles and digestive tract, and lungs are generally not involved. In severe cases, it can be fatal.

f. It is divided into primary coccidioidomycosis and secondary coccidioidomycosis.

g. Microscopic examination of fungi shows that round thick-walled spores are called spheres, which can be filled with endospores, and the fungus is cultured as biphasic bacteria.

h. Coccidiodin skin test is positive, serology test is positive.

i. The number of blood white blood cells increased, especially the number of neutrophils, the number of eosinophils increased significantly, and the erythrocyte sedimentation rate continued to increase.

2. Diagnosis:

It can be diagnosed based on medical history, clinical symptoms and laboratory examination data.

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