Global guideline for the diagnosis and management of the endemic mycoses: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology

Thompson, George R.; Le, Thuy; Chindamporn, Ariya; Kauffman, Carol A.; Alastruey‐Izquierdo, Ana; Ampel, Neil M.; Andes, David R.; Armstrong‐James, Darius; Ayanlowo, Olusola; Baddley, John W.; Barker, Bridget; Bezerra, Leila Lopes; Buitrago, María J.; Chamani-Tabriz, Leili; Chan, Jasper F W; Chayakulkeeree, Methee; Cornely, Oliver A.; Cao, Cunwei; Gangneux, Jean‐Pierre; Govender, Nelesh P.; Hagen, Ferry; Hedayati, Mohammad Taghi; Hohl, Tobias M.; Jouvion, Grégory; Kenyon, Chris; Kibbler, Christopher C.; Климко, Н Н; Kong, David Chee Ming; Krause, Robert; Lee, Low Lee; Meintjes, Graeme; Miceli, Marisa H.; Rath, Peter‐Michael; Spec, Andrej; Queiroz‐Telles, Flávio; Variava, Ebrahim; Verweij, Paul E.; Schwartz, Ilan S.; Pasqualotto, Alessandro C.

doi:10.1016/s1473-3099(21)00191-2

Cited by 149 publications

(146 citation statements)

References 73 publications

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“…In such cases, precise collection of the anamnesis can be very helpful: young age (<55), absence of past lung diseases, a job in the farming or construction sector, or traveling in endemic regions will suggest further examination for coccidioidomycosis. To confirm the diagnosis, microbiological culture, histopathological bioptate analysis, or serological testing should be used [ 14 , 15 ].…”

Section: Literature Reviewmentioning

confidence: 99%

“…Diagnosis of coccidioidomycosis can be proven by taking a culture from any clinical site (e.g., bronchoalveolar lavage or cerebrospinal fluid). Colonies of C. immitis usually take from 3 to 5 days to grow, but if the patient receives antifungal therapy during the collection of the specimen, colonies may grow up to 3 weeks [ 15 , 16 ]. If bioptate is taken, spherical structures with endospores are usually seen while examining it.…”

Section: Literature Reviewmentioning

confidence: 99%

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Pulmonary Coccidioidomycosis: A Case Report and Literature Review

et al. 2022

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Coccidioidomycosis is an infectious disease caused by Coccidioides immitis or C. posadasii fungus. Humans usually get infected by inhaling spores risen from the soil. Although in 60 percent of cases symptoms are absent, remaining patients can develop various manifestations of the disease, from flu-like symptoms to severe dissemination or meningitis. In endemic regions (California, Arizona, Mexico, Central, and South America), pulmonary coccidioidomycosis causes 25% of community-acquired cases of pneumonia. We present the first registered case of pulmonary coccidioidomycosis in Lithuania. Clinical presentation, pathogenesis, treatment options, and diagnostic alternatives are discussed.

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Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

Pulmonary Coccidioidomycosis: A Case Report and Literature Review

et al. 2022

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“…To identify and assess the morphology of fungus in tissue sections, special stains are better than the routine hematoxylin eosin (H&E) stain. Two special stains for fungi include Gomori’s methenamine silver (GMS) and periodic acid–Schiff (PAS) stains [ 17 , 24 ]. GMS with H&E counterstain can demonstrate both fungi and tissue reactions, which may help the histopathologist.…”

Section: Use Of Histopathology For Diagnosis Of Invasive Fungal Infec...mentioning

confidence: 99%

“…These may have multiple buds and resemble “ship’s wheel”, “pilot wheel”, or “Mickey Mouse ears”. Histological observations of coccidioidomycosis show tissue with spherules of various sizes (10 to 100 µm) containing numerous endospores [ 17 , 24 ].…”

Section: Accuracy Of Histopathology For Identification Of Etiologic A...mentioning

confidence: 99%

Diagnosis from Tissue: Histology and Identification

Sabino

Wiederhold

2022

JoF

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The diagnosis and initiation of appropriate treatment against invasive fungal infections depend upon accurate identification of pathogens by pathologists and clinical microbiologists. Histopathology is often critical in providing diagnostic insight in patients with suspected fungal infections, and such findings are incorporated into the definitions of proven or probable disease caused by certain pathogens. Such examinations can offer provisional identifications of fungal organisms, which can help guide initial therapy while laboratory results are pending. Common etiologic agents of invasive mycoses may be recognized based on morphologic characteristics observed in tissue and biologic fluids, such as those obtained from bronchoalveolar lavage and bronchial washings. However, care should be taken in the interpretation of these findings, as there may be a false sense of the ability to correctly categorize fungal organisms to the genus or species level by morphologic features alone. Studies have demonstrated discordant results between histopathology and laboratory results due to overlapping morphologic features, morphologic mimics, and sampling errors. Thus, histopathology plays an integral role in providing a differential of potential fungal pathogens but must be combined with results from laboratory studies, including cultures, antigen tests, serology, and molecular assays, in order to improve accuracy in the identification of etiologic agents of fungal infections. Inaccurate identification of the infecting organism can lead to inappropriate antifungal therapy and possibly poor clinical outcomes.

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“…Histoplasmosis is an infectious disease caused by fungi of the genus Histoplasma, and the most common species is Histoplasma capsulatum. In the United States (US), Histoplasma capsulatum is endemic in the Ohio and Mississippi River valleys [ 1 , 2 ]. However, autochthonous cases have been reported outside these regions (e.g., Montana and California) [ 3 , 4 ], and a substantial proportion of cases occur beyond traditional regions of endemicity [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Frequency and Duration of, and Risk Factors for, Diagnostic Delays Associated with Histoplasmosis

Arakkal

Koeneman

Cavanaugh

et al. 2022

JoF

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Histoplasmosis is often confused with other diseases leading to diagnostic delays. We estimated the incidence, length of, and risk factors for, diagnostic delays associated with histoplasmosis. Using data from IBM Marketscan, 2001–2017, we found all patients with a histoplasmosis diagnosis. We calculated the number of visits that occurred prior to the histoplasmosis diagnosis and the number of visits with symptomatically similar diagnoses (SSDs). Next, we estimated the number of visits that represented a delay using a simulation-based approach. We also computed the number of potential opportunities for diagnosis that were missed for each patient and the length of time between the first opportunity and the diagnosis. Finally, we identified risk factors for diagnostic delays using a logistic regression model. The number of SSD-related visits increased significantly in the 97 days prior to the histoplasmosis diagnosis. During this period, 97.4% of patients had a visit, and 90.1% had at least one SSD visit. We estimate that 82.9% of patients with histoplasmosis experienced at least one missed diagnostic opportunity. The average delay was 39.5 days with an average of 4.0 missed opportunities. Risk factors for diagnostic delays included prior antibiotic use, history of other pulmonary diseases, and emergency department and outpatient visits, especially during weekends. New diagnostic approaches for histoplasmosis are needed.

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Global guideline for the diagnosis and management of the endemic mycoses: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology

Cited by 149 publications

References 73 publications

Pulmonary Coccidioidomycosis: A Case Report and Literature Review

Pulmonary Coccidioidomycosis: A Case Report and Literature Review

Diagnosis from Tissue: Histology and Identification

Frequency and Duration of, and Risk Factors for, Diagnostic Delays Associated with Histoplasmosis

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