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Endemic Mycoses: Underdiagnosed and Underreported

George R. Thompson, Tom Chiller

2022Annals of Internal Medicine21 citationsDOIOpen Access PDF

Abstract

Ideas and OpinionsDecember 2022Endemic Mycoses: Underdiagnosed and UnderreportedGeorge R. Thompson III, MD and Tom M. Chiller, MD, MPHTMGeorge R. Thompson III, MDDepartment of Internal Medicine, Division of Infectious Diseases, and Department of Medical Microbiology and Immunology, University of California-Davis Medical Center, Sacramento, California (G.R.T.)Search for more papers by this author and Tom M. Chiller, MD, MPHTMCenters for Disease Control and Prevention, Mycotic Diseases Branch, Atlanta, Georgia (T.M.C.).Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-2371 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Blastomycosis, coccidioidomycosis, and histoplasmosis are the endemic mycoses that are most prevalent in North America. Exposure within the focal endemic regions is often unavoidable, and patients are frequently unaware of activities that increase individual risk. These fungi have traditionally had distinct geographic distributions, although these regions are expanding and the organisms are probably much more widespread. They occupy a specific ecological niche in the environment and are able to cause disease in healthy hosts. After the infectious “spores” are inhaled, these fungal pathogens often survive macrophage ingestion and escape, thereafter replicating and producing clinical illness.Presenting symptoms of endemic mycoses ...References1. Franklin AD, Larson L, Rauseo AM, et al. A comparison of presentations and outcomes of histoplasmosis across patients with varying immune status. Med Mycol. 2021. [PMID: 33443574] doi:10.1093/mmy/myaa112 CrossrefMedlineGoogle Scholar2. Marsden-Haug N, Goldoft M, Ralston C, et al. Coccidioidomycosis acquired in Washington State. Clin Infect Dis. 2013;56:847-50. 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[PMID: 16707052] CrossrefMedlineGoogle Scholar7. Donovan FM, Wightman P, Zong Y, et al. Delays in coccidioidomycosis diagnosis and associated healthcare utilization, Tucson, Arizona, USA. Emerg Infect Dis. 2019;25:1745-7. [PMID: 31441755] doi:10.3201/eid2509.190023 CrossrefMedlineGoogle Scholar8. Chi GC, Benedict K, Beer KD, et al. Antibiotic and antifungal treatment among persons with confirmed coccidioidomycosis - Southern California, 2011. Med Mycol. 2020;58:411-3. [PMID: 31290546] doi:10.1093/mmy/myz073 CrossrefMedlineGoogle Scholar9. Miller AC, Arakkal AT, Koeneman SH, et al. Frequency and duration of, and risk factors for, diagnostic delays associated with histoplasmosis. J Fungi (Basel). 2022;8. [PMID: 35628693] doi:10.3390/jof8050438 CrossrefMedlineGoogle Scholar10. Alpern JD, Bahr NC, Vazquez-Benitez G, et al. Diagnostic delay and antibiotic overuse in acute pulmonary blastomycosis. Open Forum Infect Dis. 2016;3:ofw078. [PMID: 27419155] doi:10.1093/ofid/ofw078 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Department of Internal Medicine, Division of Infectious Diseases, and Department of Medical Microbiology and Immunology, University of California-Davis Medical Center, Sacramento, California (G.R.T.)Centers for Disease Control and Prevention, Mycotic Diseases Branch, Atlanta, Georgia (T.M.C.).Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.Financial Support: By the National Institutes of Health (5U19AI166798-02) and the UC-Davis Burden Family Gift Fund for Research on Coccidioidomycosis.Disclosures: The authors have reported no disclosures of interest. The forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-2371.Corresponding Author: George R. Thompson III, MD, Professor of Medicine, Department of Medicine, Division of Infectious Diseases, Department of Medical Microbiology and Immunology, UC-Davis Medical Center, 4150 V Street, Suite G500, Sacramento, CA 95817; e-mail, [email protected]edu.Author Contributions: Conception and design: G.R. Thompson, T.M. Chiller.Analysis and interpretation of the data: T.M. Chiller.Drafting of the article: G.R. Thompson, T.M. Chiller.Critical revision for important intellectual content: G.R. Thompson, T.M. Chiller.Final approval of the article: G.R. Thompson, T.M. Chiller.Administrative, technical, or logistic support: G.R. Thompson.This article was published at Annals.org on 22 November 2022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals On Call - Endemic Mycoses Robert M. Centor and George R. Thompson III Metrics December 2022Volume 175, Issue 12Page: 1759-1760KeywordsAntibioticsBlastomycosisCoccidioidomycosisHistoplasmosisInfectious disease controlInfectious disease epidemiologyInfectious diseasesMycosesPneumonia ePublished: 22 November 2022 Issue Published: December 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Topics & Concepts

BlastomycosisMedicineHistoplasmosisImmunologyFungal Infections and StudiesAntifungal resistance and susceptibilityPlant Pathogens and Fungal Diseases