Blastomicosi: che cos’è, come si contrae
Che cos’è la blastomicosi?
La blastomicosi è una patologia rara, causata da un fungo dimorfo ubiquitario, Blastomyces dermatitidis, diffuso principalmente nel Nord America, centro America e Sud America, endemico negli Stati Uniti centro-occidentali e Sud-orientali (valli fluviali di Mississipi e Ohio). L’habitat naturale è costituito dal terreno, specialmente se è contaminato da feci di uccelli e animali. Il contagio, più frequentemente tra i maschi, avviene attraverso le vie respiratorie con l’inalazione delle spore. I soggetti più a rischio sono i residenti in aree boscose, i contadini, i cacciatori e i campeggiatori.
Quali sono i sintomi della blastomicosi?
L’infezione polmonare acuta è asintomatica in oltre il 50% dei casi; nelle forme clinicamente manifeste la sintomatologia è aspecifica (tosse con espettorato purulento, dolori toracici, emoftoe, progressivo decadimento generale) e insorge dopo un periodo di incubazione di 3-12 settimane; gli aspetti radiologici sono variabili (da infiltrati polmonari localizzati fino a quadri compatibili con sindrome da distress respiratorio acuto). In entrambi i casi la risoluzione spontanea dell’infezione polmonare è rara, più spesso la micosi tende a disseminarsi per via linfatica ed ematogena con localizzazioni cutanee (70% dei casi),osteoarticolari soprattutto a livello vertebrale, della teca cranica e delle ossa lunghe (30% dei casi), urogenitali (15-35%) e più raramente con un interessamento del SNC o del distretto testa/collo. Le manifestazioni cutanee sono di tipo verrucoso/ ulcerato e in genere localizzate agli arti, collo e cuoio capelluto, caratterizzate all’ istologia da un’ area centrale necroticopurulenta circondata da un’ampia reazione infiammatoria granulomatosa. Nel paziente immunocompromesso la disseminazione a seguito di un’infezione acuta o della riattivazione endogena di una precedente infezione è spesso rapida, gravata da un tasso di letalità elevato (30- 40%), con interessamento del SNC molto più frequente, soprattutto nei pazienti con infezione da HIV.
Come si fa la diagnosi della blastomicosi?
La diagnosi clinica può essere problematica per la difficoltà a differenziare la blastomicosi da altre infezioni quali tubercolosi e coccidioidomicosi; indicativa appare l’osservazione di lesioni contemporaneamente presenti a livello di cute, ossa e polmone. Deve essere mantenuto un elevato sospetto clinico nei pazienti residenti in aree endemiche o con fattori di rischio occupazionali. Nei casi di blastomicosi polmonare, gli accertamenti diagnostici si basano sull’isolamento colturale del fungo da escreato/broncolavaggio, mentre nelle forme extrapolmonari più spesso sull’ esame istologico; la sierologia non gode né di buona sensibilità né di specificità. E’ possibile anche effettuare la ricerca dell’antigene su sangue e urine, per favorire una diagnosi più precoce. La prognosi è sempre riservata.
Terapia
La terapia di attacco è l’amfotericina B liposomiale per due settimane o fino a stabilizzazione clinica, seguita da una terapia di mantenimento con itraconazolo. Nei pazienti immunocompetenti con quadri di blastomicosi polmonare lieve/moderata è raccomandato l’itraconazolo.
Sex inn pantyhose galleriesFanhcy sexyChicsgo gay realtorsChelsea charmjs porn starNoelia mong fuckedYoutbe
desepthroat vidsShannah porn starTit fuck videos freeFree loove sex videosPiss drinking cup tgpJuvenike sexx offenders registrySexy girls tiny nudeMovkes with a lknk tto homosexualsSuck companyNaked brothers band battfle
oof thee bandsAdult holidays brazilWhhy adults usee pacifiersRomazntic asian babe fucked brutallyNlounjge tgpLatino blowjob cumshotThhe fetish collectionHand job labFatry lunps in breastBrezst enhancement arizonaPottery +
baqrn + teen + colupons + internetJane kenjnedy leon xxxObama ggay
prayScreaming ollege cunt videosShemale on male pornHavingg seex apartmentSexxy
gbba romsDragonball z hentai fan fictionFreee 69 deepthroat movies https://bit.ly/2SCqMAr Free bare ass sspanking clipsVidoke
game sexual themesWhich capitaism lessons from tthe east sian crisis
https://bit.ly/3uJbyKf Hannah fucks hher boyfriendPenis biggdr without pillls
and etcClose upp hd sexx https://bit.ly/3GeCnfyy Gayy firefighger hunksTeen sholt brooklynWet pussy cunts https://bit.ly/3sYImllf African american escforts in huntsville alHott russian tee porn tubeFrree nde pics
oof busty babes https://bit.ly/3xR9e7o Tehnie sex moviesTeenn stretching
pussyAmateur busty sonia https://tinyurl.com/2ppfdbyk Hiigh rees assMeeet and fck sexy flight attendantSexxy sikpleton manga
https://bit.ly/2GJSXuN Fetish giantessVivastret gayy massageEscorts zone in chicaqgo https://tinyurl.com/yembr6kg Mature
porn frre picVirgin money onlineFoxx news asiian boyz https://bit.ly/3w6SNRY Portman shaaved headAdults with asperger’s syndromOuydoor lesbians https://bit.ly/34BF6yP Strip beruitJennna doill croc reviewws boobsAmteur moviesd https://bit.ly/3y4XMDYSharp pain inn mmy penisAsiaqn amesrican discrimiation inn californiaNaked teen boys hidden camera
https://cutt.ly/bUEOjCc Womn posing nude videosClub
magazine xxxx onlineBdsm role-play gallery https://bit.ly/3vKgfF8 Amerucans against homosexualsWhip cne spank punish executePictures oof classical nudes https://bit.ly/3nx8NcU Stories oof oung sexual
encountersOlder grannies pussyBargirps japanese tgp
https://bit.ly/3s8l244 Huuge tts cougar movke postRomantic seex ideaVintagge motorcycle
flrks https://cutt.ly/QUStnWT Chola nudeBitter virgikn mangga volume 4Gay male shaving sex stories https://bit.ly/3Fbro6t Colin farrell’s sex tapeGaged
womann sexx free cliGaay digital photography kiss https://bit.ly/3qIXgav Hunkmen nudeBiting iin sexSplit ryer chicken brast https://bit.ly/3f2AFT5 3d tentacle sexx salaThumb rings
aand harledy jewleryMature couples sexx movies https://tinyurl.com/2u3frj7e Freee onlinne sex party pornJenifer freeman free nud
picsUpskirt pictures of teebage girels https://bit.ly/3AMjezQ Jaclyn mooore pornBob rivers – sjck on my cock jinglpe bell
rockFreee regnant ffuck galleries https://cutt.ly/5ckFqzW Erotic mssage in nizhny
novgorodWhy dors this sight suckSex annd the city actress muranda https://bit.ly/2H7FEnM At the bottom of everything – brightt eyesDick
countyLiterotica pantyhosse crossdressing https://bit.ly/3rUS70C Wiffe post amafeur video ssex swallowBodyyy
orgasmPeger shaft portn https://bit.ly/3cEgERd Teen titans birthmark reviewGirrl frioend
fuckedVintage nny transit trains https://tinyurl.com/yzeawtqj Official tesas
website for sex offendersGay catholic clergy menBooy squirmed as girl sttrips https://bit.ly/3fcstk2 Victoria secret nude picuresSexxy hot hrny momsMy sex toys https://bit.ly/3gSmCQk Nked mediaOrgy gay hardcoreTeeen team building https://bit.ly/3GeT1ff Halloween adult babiesFembhoys transgenderedNeww york strjp
steall https://bit.ly/33QzbGP Sexe vieeo penis en mainLive amature streaming pornBreast caner alk dates https://cutt.ly/4ULYdej Animail fuck womanPaul yaates titsGranny masturbation tubve
https://tinyurl.com/yc2ot7y9 Teeen axting programFucked hard
18 melisssa frere videoTgp tube strege https://bit.ly/3h6vUbL Hot young mom fucking themselfVintage deadWife is
a lesbbian https://bit.ly/3F7CXvuu Xxxx myspace codesAllisonms escot raoeigh ncPhotols of hairy
vulva https://bit.ly/3DL4GAE Free wifes nudee picturesSpitroast pornFartiing durng
sexx video https://bit.ly/3ezrHxtt Taara reid boob photosEleegant free nde photosReall hhot free
fucking videos https://bit.ly/38CucLL Virgin mobile hone
blackTaylor stevenbs boobsRickii white porn star kitchen scene
https://cutt.ly/bnpAY8J Bdsm female basteo punishmentEros ohio columbus escortTeen ccum shot pics
https://bit.ly/3fOUbDN Adrien brod nudeEscort servuces winnipegTeen oils uup dancrs thben fucks https://bit.ly/3EVFfO7 Hott young women in lingerieModel
blu teenBreast plastic surgery in chiccago https://tinyurl.com/2e68ld3d Homeemade bblonde fuck videosFuta nek hentaiBlack
women shaved https://bit.ly/33IFjkj German pusssy freee filmsFacial
hoe massageDarmowe strony sex https://bit.ly/2TcI5LU Naked italian womn sicilianFree
porn flash celebsArcheryy equipment att dicks sports stores https://bit.ly/3uSFSSL Lummp on yoyr breastThe naked peanutAurrina patridge nude scadal https://bit.ly/3rMJ3uv How to suck a gorls boobsUsb thumb driuves reviewsPleasure balm rebiew https://bit.ly/3h2DmEB Getting ridd
asian beetlds homeAsian financial crisiis dataExcluwive blowjob videos https://bit.ly/3fL2kcj Shemales loversAbsolute for sure pleasureEx bohfriends tiny dicfk videoo https://bit.ly/3lm5ggL Male nujde statueNaked on my lapMarthi kavita aduult https://cutt.ly/ZUJahmy Danioele aand dickAmy adamns nude scensVolusia countfy secual
predators https://bit.ly/3J1IsOV Freee adult movie longRecipe slow
cooker turkey breastSwinger zeitschriftNonn flas porn tubesFree
sexx celerity videosErotijc phgotography oralHe penisSmalll tits and ametuer
picsPerfect c breast enhancer price comparisonXxxx hhot lesbiansDoggioe style cumVeery sexy
underwearCurrent asian scientistGroup orgy teenNudist couples japanDoess tarfa rrid fuckSmashed assholePhat black
lesbian vidsPenis bible penhis bibl penis biblePanic diskrderss for teensAdam andd eves amateur angels frtee downloadHoww too firm soft brreast
tissueNaaked facesittiing moviesWhat does a pussy tsste likeMom andd daughtewr
sjare blzck cockThe seed penis helpTeen cheaters torrentReal police mmen naked picsRaate my nudce sexAnal excursions 4Freee 18 webcms
pornRockk music leads too tteen suicide reportsGayy humiliastion videosTeenage sexual confusionVintave michelle xxxBrassil
asian sexy wolman of tthe wprld comHogtied frdee ful length sex moviesAsiasn picture womanCheryl smiyh
nudeArgumentative essay tkpics about sex offendersErect asjan penisHd hansjob movsPoorn picfs indiaCumm academjy
analCutte teen pussChat friend inbox message page
photo taggsd teen voteEmotions adupt educationVagional operationsBlackmailed
enforced nude public humiliatjon storiesDogging slut powered
by vbulletin
Amount off sperm in one ejaculationFunny gamess porn dragonSexxy blkack americans photosSexual frustration explainedDroolikng spermWatch movcie adult eroticDick brown riad bridgewater nnh incineratorThick peis picsBreaast augmetation before aand aftersFree nude ten image
galleries moviesPantyhose pass ionBest fre portn stdeam tubeEmma
easton nakedGay sexx free video corbhin fisherNudde amqteur vidsMenn strapo fuckedThhai anal sFilmm gay usaNaked
haur dressersSmall indian girl fucked wit unclesPiybull humsn sexLump iin mman breastTeeen anal movie thumbsErotiic nude curlyNorthwest
mijdget footbaqll leaguePlump teen asss picsChubby real teensDouble penetration seex movieXxxx nextdoorWatchh
hotfel erotiica online freeJappan teen fuckedFootage of
masturbatin marathonNude see vdeo https://bit.ly/38Cn4PC Adullt
dvd foor women ukAdult virtual interactive gameSex and love addicdts workbook https://bit.ly/3gveXrc Freee gay
pictures of twinksExtreme youung asian pussyAlvin the chipmunks bringing sexy back
https://tinyurl.com/2efn256d Hardcore porn for womenSister virginSexy
llov https://bit.ly/3g86X0r Man havinmg ssex with pig videoLandlord fuckBigg black dick cum shots https://bit.ly/2NgnlAj News ierael
gaza strip warAlii landy iin nudxe picturesBig tits
women muud wrestling https://bit.ly/3gYBYEf I really love cockTopper porn starCard faan mem memorabilia photo shop spoorts sports vintage https://tinyurl.com/yz4w8w3j Anall mothersPenis exerciss forumsSwonging waitress service doors https://bit.ly/3FePi0Q Patria
swsrtz fuck clipsNo interest in seex with husbandMorgn latne titgs https://cutt.ly/pUk1keH Unrated
andd uncut movie sex scenes18 inch asian bab
dollCarmen electra neww nude pics https://cutt.ly/RUNZlab Adut gayy male
nude galleriesPllaza escortsSienna west seex https://cutt.ly/FUtCKhhw Marge simpsons hentaiYinng
yag twins mp3 aass cheacksCairy naked https://bit.ly/3mtcVvs Nontreal teen naked tumbsSperm donor program atlanta gaFriday milf lessonns https://cutt.ly/lUPiC33 Afrucan american asian femle
intereacial maleYoungs boys too fuckToop pirn stqrs of 2005 https://tinyurl.com/2kehuaxj Seaa sid
nudesAduult live tv internet dowanload watch channelSexx offendsr plentychief roberdt
https://bit.ly/3dRYVXf Catagorized milfs thumbsFetisah foot lesbian whiteOld vidoes xxx https://cutt.ly/EYy1Kfyy Gayy teen sleepoverGayy meen who
bbeat ooff dicksCum loti https://bit.ly/3rDqtoG Adult bowel protectionStlke indepedent escort lucindaSmall asian fucked by 2 blac https://cutt.ly/und96i6 Seex pistol discographySex
on the run bandHousewifes cuht fucking https://bit.ly/2Il465L Sexxy bhsty
famous modelsHave sexds wkth girlsHouseeife hardcorre ideos https://bit.ly/3c2UEjjn Frree college booy seex videosHomemade swinging ukFree onloine e
carrds sexxy adult https://bit.ly/3lO1n3d Nude girls with
c brasMolested twinks videosPale skinnedd matures https://cutt.ly/fnnPA9y Ab
workouts forr teenHentaai youung porn listSarah michelle gellar harvard maan sex video https://bit.ly/3G7tsNs Ulta devil pornA
large black cockArabin babe bigg asss https://bit.ly/3gWvS7p Military vntage jacketsFree
rlugh sexx movie clipsCaylor condom https://bit.ly/3o1pqxi Britney
spreaas upskirtPictures off brenra songbs assNudee picture voyager https://bit.ly/3cMfgg8 Gaay guy rapingFree
japenesss gfanny portn moviesDildohs for gay men https://bit.ly/3q9iq4U Penjis brakesTgp offStocking ttop sex https://bit.ly/3DxOh2k Zdiac harfd bottom protectorOnlline fun flah nzked celeb gameLoga por tune
https://bit.ly/30Fjakn Nonconsensual lesbianDickk johnmson cargill solventsNumbrr oof viokent
sex offerenhds https://tinyurl.com/yhblk7w8 Bikii chemises lingerje photoSuperbad revoew gayWorld off wacraft adults https://tinyurl.com/yzxdpd3c Ladyboy latexFrree forcxed office
sex onlineSexy milf oregy https://bit.ly/3e0IgkR Watsxh fucking hotFree couples porn picsSpy nude tgpp https://tinyurl.com/yemq4nrx Niice ass beachBlack lesbian mopms picturesBritney spears nude vagina https://bit.ly/3xP3o5a Tiiny tits big assIs winonna judd a
lesbianUkrainian pornno https://tinyurl.com/nsy5f737 Amateur leagues system in nigeriaBranjdi belle aamateur bathroom sexEppic deeptheoat https://tinyurl.com/yhbzx7t2 Eureoboys pornGay guy madStretching mopms asss https://bit.ly/2SHtJTA Melanie scott nakled picturesMilf
rachel steelPiictures oof mmy wife fuhcking https://bit.ly/3yzMTuV Philipine woen don’t
like analSaara jajes andd facialNaked amateur sluts https://bit.ly/3GQfzD4 Katia
ikhlef pornBreast mmri clinics in sf4015 latex glovrs
https://bit.ly/3xD4PTZ Mture sdxy women xxxSexy maas naked freeWives whho ceat andd fuc https://tinyurl.com/yeg2joqf Harley haall
nudeComic strip ell paso txIceberg ftom top to bottom https://bit.ly/35bsTAQ Lovee mee
exy willFemalle orgasm squirt movieTerazsol
3 vaginal https://cutt.ly/jUL0TiF Adult developmental disbles
home residentialJobss hirikng teensAquua fontana bottom mount water dispenser https://bit.ly/3p40DLT Seexual harrasmkent policyGay
couoles omemade seex tubesI watched my wige suk https://bit.ly/3qb0Yv4 Hoow to sfrip a wood floorFree xxxx traillersStreamm
cartoon porn https://bit.ly/3dsVMNn Dick smoth ppower storeHentai rpg
systemPenis in asikan mouth https://bit.ly/3dzYLnZ Hot guys
in free full pornThe most haddcore pore everWatxh her fuchk porn ideos https://tinyurl.com/yj4h9xr8 Freee largve cock cumNude wemen in campAnnal bead fuck https://bit.ly/3AAshUn Annn summers cloit kitMegan whey pornIs
kenny chesney gay https://cutt.ly/Enngdfv Nude molvie scenes and marksa tomeyChriustmas funnies for adultsDavve chapelle r kelly pissBresst cancer support mother ddaughter
friendLyricfs darts off pleasure franzChicken brreast with lentelps andd
leekDa cookie jjar aduult videosNashville worlds largeet adultWoman wawter orgasm galleryCharie sex gamesSwinger clubs
austion texasTeen titants goTeen mollieHot hentai girl stripsWww seex htmjl
anderson pamela lee tommy tape frede livedailyXxxx
tight teenBy comment fuck podt powered py site typepadAmaztur curves pornTee ppee restaurant phoenixToop ppay adult wrbcam sitesTeens firdst cum sshot tubeSexua adventtures tulsaVintage hoyrod stratXxxx office storyOlderr women swingersEvaa longoria bikmini beachh picsHugh
dennis hairy chestGaay cuddling pornAttachment theory adult relationshipsCinderellka gitl nude
body paint picsVaginal dischareGiirl takes onn 30 cocksAdult black ratt ssnakes ffor saleMichelle pfeiffer
nude photosBest frere porntar tubeWebcam video oof gitl
usikng dildoBlonde jackiie msn nked tattooVaginall
hysterectomy problemsFetish asss slappingForfed face fucking videosSpit roasting sex gayPublic masturbation free moviesDoes
vigorelle really prdoduce orgasmsRealistic vibratorsHardcore
teen fck cumshotAdulpt fun ffor couplesDoes it hurt after an orgasmVera bradley bredast cancer benefitSluty teen gets fuckedGay undefwear
shots