Endemic and Other Dimorphic Mycoses in The Americas

Abstract

Endemic fungi are thermally dimorphic fungi that have a limited geographic range and can cause both primary disease and opportunistic infections. The Americas are home to more genera of endemic fungi than anywhere else on earth. These include Coccidioides, Histoplasma, Blastomyces, Paracoccidioides, and Sporothrix. Endemic fungi are found across the Americas and the Caribbean, from Blastomyces gilchristi, which extends into the northeast corners of North America, to Histoplasma capsulatum, which occurs all the way down in the southern regions of South America and into the Caribbean Islands. Symptoms of endemic fungal infection, when present, mimic those of many other diseases and are often diagnosed only after initial treatment for a bacterial or viral disease has failed. Endemic fungi place a significant medical burden on the populations they affect, especially in immunocompromised individuals and in resource-limited settings. This review summarizes the ecology, geographical range, epidemiology, and disease forms of the endemic fungi found in the Americas. An emphasis is placed on new and proposed taxonomic changes, including the assignment of new species names in Histoplasma, Blastomyces, and Paracoccidioides.

Testing Practices for Fungal Respiratory Infections and SARS-CoV-2 among Infectious Disease Specialists, United States

“…Our results show that respondents rely more frequently on epidemiologic exposures, geography, and host factors, rather than negative SARS-CoV-2 testing or lack of clinical improvement, to guide testing decisions for certain fungal infections. Although the survey did not ask about factors influencing testing decisions for patients without COVID-19, it is critical for clinicians to remember when considering testing that many patients with these fungal infections do not have clear epidemiologic exposures, that the regions where these infections can occur are wider than are often appreciated, and that severe disease can occur among people without underlying conditions [17].…”

Occupational Histoplasmosis: Epidemiology and Prevention Measures

“…Based on public health surveillance, environmental data, and outbreak investigations, the geographic distribution of histoplasmosis is likely wider than currently recognized [ 10 , 21 ]. Similarly, estimates of case counts and incidence are likely subject to underreporting and misdiagnosis [ 22 ].…”

Endemic mycoses: Expansion of traditional geographic ranges and pitfalls in management

“…A number of novel species have been recently described although species level identification is rarely needed during clinical care (Table 1). 1 Histoplasma spp. are common throughout the Mississippi, Ohio and St. Lawrence River valleys, the Caribbean, parts of Central and South America, Africa and Asia although have now been described in central Europe and New York state; Coccidioides within the southwestern United States, and parts of central and South America yet now has been described as far north as Washington and to the midwest in Missouri; Paracoccidioides within Central and South America; Blastomyces within the Mississippi and Ohio River basins, St. Lawrence Seaway, with novel species observed in several Canadian provinces 2 and sporadic cases in Africa, Central and South America 3 ; Sporothrix is found worldwide and seems to be adapting to mammalian body temperature with a shift from sapropytic to zoonotic in some locations 4 ; and Talaromyces in Southeast Asia, India, Southern China and Hong Kong is now a frequent opportunistic infection in the HIV population 5 …”