Neglected endemic mycoses

Queiroz‐Telles, Flávio; Fahal, Ahmed H.; Falci, Diego Rodrigues; Cáceres, Diego H.; Chiller, Tom; Pasqualotto, Alessandro C.

doi:10.1016/s1473-3099(17)30306-7

Cited by 221 publications

(240 citation statements)

References 88 publications

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“…Chromoblastomycosis is primarily of the tropics and subtropics. It is observed in Central and South America, Cuba, Jamaica, Martinique, India, South Africa, Madagascar, Australia, rarely in North America, and Europe . However, recently a native case of Poland has been described.…”

Section: Discussionmentioning

confidence: 99%

Chromoblastomycosis: clinical experience and review of literature

2018

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Section: Discussionmentioning

confidence: 99%

Chromoblastomycosis: clinical experience and review of literature

2018

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“…Despite the significant burden of fungal infections in Latin America and the Caribbean, insufficient attention to the problem seems to occur, with lack of awareness from both society and governments . Histoplasmosis and paracoccidiomycosis are examples of endemic infections with high incidence rates in the region . In a similar fashion as in the developed world, opportunistic infections like aspergillosis and candidosis affect an emergent contingent of immunocompromised hosts in Latin America and the Caribbean.…”

Section: Introductionmentioning

confidence: 99%

Clinical mycology in Latin America and the Caribbean: A snapshot of diagnostic and therapeutic capabilities

Falci

Pasqualotto

2019

Mycoses

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Summary Despite the existence of endemic mycoses in Latin America and the Caribbean, in addition to a large population of patients at risk for invasive mycoses, the capability of medical centres to perform a proper diagnosis in mycology has not been studied in the region. Moreover, availability of antifungal drugs in the region is unknown. Here, we report the results of a survey involving 129 centres in 24 countries. Only 9% of centres would have the potential to apply for the minimum standards in mycology, as determined by the European Confederation of Medical Mycology. There is an urgent need to improve diagnostic conditions in Latin America and the Caribbean, as well as providing access to safer and more efficacious antifungal drugs.

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“…Histoplasmosis and talaromycosis usually require a period of 2 weeks of induction therapy followed by 6-12 weeks of consolidated treatment, while paracoccidioidomycosis and sporotrichosis usually require long-term treatment of at least 12 months [14,51,52]. Generally, the duration should be guided by clinical improvement and radiological resolution.…”

Section: Duration Of Itraconazole Treatmentmentioning

confidence: 99%

Diagnosis and Management of Systemic Endemic Mycoses Causing Pulmonary Disease

et al. 2018

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Systemic endemic mycoses cause high rates of morbidity and mortality in certain regions of the world and the real impact on global health is not well understood. Diagnosis and management remain challenging, especially in low-prevalence settings, where disease awareness is lacking. The main challenges include the variability of clinical presentation, the fastidious and slow-growing nature of the fungal pathogens, the paucity of diagnostic tests, and the lack of options and toxicity of antifungal drugs. Coccidioidomycosis and paracoccidioidomycosis are restricted to the Americas only, and while histoplasmosis and blastomycosis also occur predominantly in the Americas, these mycoses have also been reported on other continents, especially in sub-Saharan Africa. Talaromycosis is endemic in tropical and subtropical regions in South-East Asia and southern China. Systemic endemic mycoses causing pulmonary disease are usually acquired via the airborne route by inhalation of fungal spores. Infections can range from asymptomatic or mild with flu-like illnesses to severe pulmonary or disseminated diseases. Skin involvement is frequent in patients with paracoccidioidomycosis, blastomycosis, sporotrichosis, and talaromycosis and manifests as localized lesions or diffuse nodules in disseminated disease, but can also occur with other endemic mycoses. Culture and/or characteristic histopathology from clinical samples is the diagnostic standard for endemic mycoses. Immunological assays are often not available for the diagnosis of most endemic mycoses and molecular amplification methods for the detection of fungal nucleic acids are not standardized at present. The first-line treatment for mild to moderate histoplasmosis, paracoccidioidomycosis, blastomycosis, sporotrichosis, and talaromycosis is itraconazole. Severe illness is treated with amphotericin B. Patients with severe coccidioidomycosis should receive fluconazole. Treatment duration depends on the specific endemic mycosis, the severity of disease, and the immune status of the patient, ranging between 6 weeks and lifelong treatment.

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Neglected endemic mycoses

Cited by 221 publications

References 88 publications

Chromoblastomycosis: clinical experience and review of literature

Chromoblastomycosis: clinical experience and review of literature

Clinical mycology in Latin America and the Caribbean: A snapshot of diagnostic and therapeutic capabilities

Diagnosis and Management of Systemic Endemic Mycoses Causing Pulmonary Disease

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