Koktsidiomikoz — the disease caused by fungi of Coccidioides immitis and which is followed by formation of inflammatory infiltrates of various size in lungs, skin and bones. Infection koktsidiomikozy occurs generally through respiratory organs, is more rare through skin. Diagnostics is based on identification of the activator at a microscopic research and crops of separated. Treatment of a koktsidiomikoz consists in use of modern antifungal medicines.
Koktsidiomikoz is widespread in steppe and desert areas, he is endemic, that is tied to a certain environment, a disease. In Europe meets in isolated cases whereas in some regions of the USA various displays of this disease are noted at 60% of the population.
Causes of a koktsidiomikoz
Koktsidiomikoz is a fungal disease. Its activator - a mushroom of Coccidioides immitis which development happens in the soil. With dust disputes of a mushroom are carried by air and can get into a human body at inhalation. Infection koktsidiomikozy is possible through the damaged covers of skin or through mucous digestive tract at the use of the products infected with disputes. Cases of infection of the person from sick people or animals are not revealed.
Symptoms of a koktsidiomikoz
Koktsidiomikoz develops 7-18 days later after infection through airways. At infection through integuments this period increases about one month and more. At the majority infected (about 60%) primary infection has an asymptomatic current. A quarter infected koktsidiomikozy has a damage of respiratory organs which proceeds as a SARS in the beginning. Then cough, short wind and breast pains joins. In lungs there are small centers of an inflammation - granulomas which can merge, sometimes striking the whole share. The clinical picture corresponds to bronchitis or pneumonia, pleurisy in certain cases develops.
Involvement of skin in infectious process happens, as a rule, 1-2 weeks later after the beginning of pulmonary manifestations. At infection koktsidiomikozy through skin skin manifestations arise without the previous changes from respiratory organs. More often skin of extremities, the heads and necks is surprised. Rash has character of a knotty eritema and is caused by emergence in skin of small inflammatory infiltrates. Formation in skin of abscesses and emergence of nodular and ulcer elements is possible. After opening of skin infiltrates there are ulcers which bottom is covered with vegetations. , ulcers leave star-shaped hems. Rash at a koktsidiomikoza can be followed by morbidity and a swelling of joints.
Koktsidiomikoz is dangerous by development of a septic (generalized) form of a disease at which the infection on blood vessels can extend in any body with education in it fungal granulomas. Granulomas are inclined to purulent fusion therefore the generalized form of a koktsidiomikoz proceeds very hard with the expressed intoxication and can lead to a lethal outcome. Spread of an infection to covers and substance of a brain with development of abscesses and purulent meningitis is the most dangerous.
Several years later or months after the postponed sharp koktsidiomikoz can arise secondary of which the heavy progressing current with extensive defeats of pulmonary fabric, edges and vertebras, and also with formation of infiltrates in an abdominal cavity is characteristic.
Diagnostics and treatment of a koktsidiomikoz
The activator of a koktsidiomikoz can be revealed at microscopy of specially painted dabs received from a phlegm, separated skin elements, a punktata of pleural or articulate liquid. For confirmation of a koktsidiomikoz and definition of sensitivity of the activator to antifungal medicines carry out crops separated or phlegms. For serological diagnostics of a koktsidiomikoz use reaction of linkng of a compliment with a specific anti-gene (RSK). Carry out tests with drawing on skin of a koktsidioidin. However it is necessary to consider that skin tests are positive within several years after the postponed koktsidiomikoz.
If proceeds with damage of respiratory organs, then on roentgenograms of lungs the centers of pneumonia or abscesses are defined. At emergence of symptoms of meningitis make a lyumbalny puncture with the subsequent research of cerebrospinal fluid. According to indications carry out a puncture of a joint or a pleural puncture.
Depending on a form and weight of a koktsidiomikoz treatment is carried out by intake, intravenous or intramuscular administration of antifungal means ( In), a pozakonazol or various medicines of a flukonazol.