Mycotic Infections Acquired outside Areas of Known Endemicity, United States

Benedict, Kaitlin; Thompson, George R.; Deresinski, Stan; Chiller, Tom

doi:10.3201/eid2111.141950

Cited by 76 publications

(60 citation statements)

References 38 publications

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“…Notably, recent findings demonstrating the presence of Coccidioides in the Pacific Northwest, specifically south central Washington, have challenged our current understanding of where this fungus resides and have highlighted the need to generate more accurate distribution maps [19–21]. Although surveillance methods that involve skin testing or serological assays that detect Coccidioides exposure in humans are available [11, 22, 23], it is becoming increasingly difficult to find people with limited travel history between known and unknown endemic areas.…”

Section: Introductionmentioning

confidence: 99%

Development of an enzyme immunoassay for detection of antibodies against Coccidioides in dogs and other mammalian species

et al. 2017

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Coccidioides is a soil-dwelling fungus that causes coccidioidomycosis, a disease also known as Valley fever, which affects humans and a variety of animal species. Recent findings of Coccidioides in new, unexpected areas of the United States have demonstrated the need for a better understanding of its geographic distribution. Large serological studies on animals could provide important information on the geographic distribution of this pathogen. To facilitate such studies, we used protein A/G, a recombinant protein that binds IgG antibodies from a variety of mammalian species, to develop an enzyme immunoassay (EIA) that detects IgG antibodies against Coccidioides in a highly sensitive and high-throughput manner. We showed the potential of this assay to be adapted to multiple animal species by testing a collection of serum and/or plasma samples from dogs, mice, and humans with or without confirmed coccidioidomycosis. We then evaluated the performance of the assay in dogs, using sera from dogs residing in a highly endemic area, and found seropositivity rates significantly higher than those in dogs of non-endemic areas. We further evaluated the specificity of the assay in dogs infected with other fungal pathogens known to cross-react with Coccidioides. Finally, we used the assay to perform a cross-sectional serosurvey investigating dogs from Washington, a state in which infection with Coccidioides has recently been documented. In summary, we have developed a Coccidioides EIA for the detection of antibodies in canines that is more sensitive and has higher throughput than currently available methods, and by testing this assay in mice and humans, we have shown a proof of principle of its adaptability for other animal species.

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Section: Introductionmentioning

confidence: 99%

Development of an enzyme immunoassay for detection of antibodies against Coccidioides in dogs and other mammalian species

et al. 2017

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“…Histoplasma capsulatum is one of the most common thermally dimorphic fungi, and though classic areas of endemicity along the Ohio and Mississippi River Valleys have been described, there is increasing recognition of histoplasmosis outside of these areas [1, 2]. H. capsulatum is a rare cause of infectious endocarditis, with only 58 previously described cases [3, 4].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Importance of Hyphae on Heart Valve Tissue in Histoplasma Endocarditis and Treatment With Isavuconazole

Wiley

Woodworth

Jacob

et al. 2017

Open Forum Infectious Diseases

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“…The reported use of antigen detection in non-United States cases of imported histoplasmosis is very limited: performance of an antigen test (in urine and/or serum) was declared only in 9 out of 319 cases of histoplasmosis in immunocompetent travelers diagnosed out of the United States (Staffolani et al, 2018). Even in non-endemic areas of the United States, the use of the EIA antigen detection has been seldom reported (Benedict et al, 2015). The underlying reason may be at least partially related to the overall scarcity of imported cases, making the test non-costeffective in settings of no endemicity.…”

Section: Handicaps Of Laboratory Diagnosis In Non-endemic Areasmentioning

confidence: 99%

Timely Diagnosis of Histoplasmosis in Non-endemic Countries: A Laboratory Challenge

Buitrago

Martín-Gómez

2020

Front. Microbiol.

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Human histoplasmosis is a fungal infection caused by the inhalation of microconidia of the thermally dimorphic fungi Histoplasma capsulatum. Autochthonous cases of histoplasmosis have been diagnosed in almost every country, but it is considered an endemic infection in specific areas of the world. Many of them are popular travel destinations or the source of migratory movements. Thus, the vast majority of the registered cases in non-endemic countries are imported. They correspond to people having been exposed to the fungus in endemic locations as immigrants, expatriates, transient workers or tourists, with reported cases also associated to organ donation. Misdiagnosis and delays in initiation of treatment are not uncommon in cases of imported histoplasmosis. They are associated to high fatality-rates specially in patients with compromised cellular immunity in which progressive disseminated forms develop. The diagnosis of this infection in non-endemic countries is hampered by the lack of clinical suspicion and a dearth of available diagnostic tools adequate to offer rapid and accurate results. Non-culture-based assays such as nucleic-acid amplification tests present as a suitable alternative in this situation, offering improved sensitivity and specificity, shortened turnaround time, and increased biosafety by avoiding culture manipulation. In non-endemic regions, molecular techniques are being used mainly in laboratories from countries that have registered an increase in the incidence of imported cases. However, the number of published techniques is limited and lack consensus. Efforts are currently under way to standardize nucleic acid amplificationbased techniques for its implementation in areas registering a rising number of imported cases.

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Mycotic Infections Acquired outside Areas of Known Endemicity, United States

Abstract: ncreased awareness that mycoses can be acquired in unusual geographic locations is needed to promote early diagnosis and treatment.

Cited by 76 publications

References 38 publications

Development of an enzyme immunoassay for detection of antibodies against Coccidioides in dogs and other mammalian species

Development of an enzyme immunoassay for detection of antibodies against Coccidioides in dogs and other mammalian species

Diagnostic Importance of Hyphae on Heart Valve Tissue in Histoplasma Endocarditis and Treatment With Isavuconazole

Timely Diagnosis of Histoplasmosis in Non-endemic Countries: A Laboratory Challenge

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