洞穴探险与洞穴病－组织胞浆菌病

孙承航

doi:10.11932/karst2023y016

洞穴探险与洞穴病－组织胞浆菌病

doi: 10.11932/karst2023y016

孙承航

中国医学科学院&北京协和医学院医药生物技术研究所, 北京 100050

基金项目: 中国医学科学院医学与健康科技创新工程项目（ CIFMS2021-I2M-1-028）

详细信息

作者简介:
孙承航（1966－），男，研究员，主要从事特殊生态环境微生物与抗感染药物发现的科研与教学工作。E-mail：chenghangsun@hotmail.com , chenghangsun@hotmail.com

中图分类号: R519
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出版历程
- 收稿日期: 2022-10-05
- 录用日期: 2022-12-15
- 修回日期: 2022-10-19
- 网络出版日期: 2023-04-10
- 刊出日期: 2023-06-30

Cave expedition and histoplasmosis, a kind of cave disease

SUN Chenghang

Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China

摘要

摘要: 文章介绍了一种与洞穴探险关系密切的深部真菌感染性疾病－组织胞浆菌病，回顾了组织胞浆菌病及其病原真菌，荚膜组织胞浆菌的发现、洞穴病的提出、洞穴中感染源和传播途径的研究历程。结合世界及我国洞穴中组织胞浆菌病爆发的实例，介绍了预防组织胞浆菌病的相关知识，并为安全地开展洞穴探险提供了建议。
- 组织胞浆菌病 /
- 荚膜组织胞浆菌 /
- 洞穴 /
- 真菌 /
- 蝙蝠
Abstract: Histoplasmosis is an invasive fungal infection, which might breakout among people who are exposed to the Histoplasma capsulatum, usually, Histoplasma capsulatum var. capsulatum. This disease is an occupational disease of cave explorers, but many cavers or cave managers have never learned, or known very little about it. In order to popularize the disease and its prevention among karst cave geologists, cave explorers and managers, this review introduced histoplasmosis through seven sections following the introduction of histoplasmosis as one of the threats faced by cavers during cave survey in the preface. The first section retrospect research history about the discovery of histoplasmosis and its pathogenic fungus, Histoplasma capsulatum, on the basis of papers published by US scientists, Samuel T. Darling in 1906 and 1908, William DeMonbreun in 1934 and 1939, as well as Chester W. Emmons in 1947 and 1948. The second section introduced definition of cave sickness and investigation on the source of infection in cave. The third section summarized the research evidence how bat spread Histoplasma capsulatum to caver, some important papers published in Science by Martha H. Shacklette in 1962 and Marinkelle C J in 1965 were cited in the section. The fourth and fifth section discussed geographical distribution of histoplasmosis in the world and in China, respectively. Furthermore, in the fifth section, the analysis of histoplasmosis cases in China from three different groups in different period, such as case statistics of 1990-2011 by Pan Bo from Shanghai Changzheng Hospital, case statistics of 2001-2014 by Yu Jie from Huashan Hospital and case statistics of 2001-2019 by LYU Xin from Xiangya Hospital, all data showed Yunnan, Hubei, Hunan, Chongqing, Jiangsu, Guangdong, Sichuan, Zhejiang,Shanghai,Guangxi, most cases came from in China. Meanwhile, in the fifth section, the earliest histoplasmosis cases in China in 1950s were looked back. On the basis of histoplasmosis outbreaks in China and the World, the sixth section summarized the knowledge on how to protect cavers from histoplasmosis infection during cave exploration and provided suggestion about how to prevent histoplasmosis outbreaks for cave managers and local health authorities. In addition, a real story on an outbreak of febrile histoplasmosis among Chinese manganese-mine workers in cooperative Republic of Guyana in 2019 was stated on the basis of two papers published in China CDC Weekly, 2019 and Chinese Journal Infection Chemotherapy, 2020 and one thesis published by Chongqing Medical University in 2021. In the final section, it was emphasized how to prevent to carry unintentionally Histoplasma capsulatum through the caving equipment during international visit for joint expedition.
- histoplasmosis /
- Histoplasma capsulatum /
- cave /
- fungus /
- bat

HTML

图 1 荚膜组织胞浆菌(来自美国疾病控制与预防中心, 公共卫生影像图书馆)

Figure 1. Histoplasma capsulatum. (From US Centers for Disease Control and Prevention. Public Health Image Library. PHIL ID #15364. Available at https://phil.cdc.gov/ Details.aspx?pid=15364)

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图 2 急性组织胞浆菌病肺炎典型粟粒结节(胸部CT)

Figure 2. An axial slice from a computed tomography study of the chest at the level of the carina that shows the classic miliary nodular appearance of acute histoplasmosis pneumonia. (From US Centers for Disease Control and Prevention. Public Health Image Library. PHIL ID #472. Available at https://phil.cdc.gov/Details.aspx?pid=472)

下载: 全尺寸图片幻灯片

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