Outbreak of Histoplasmosis in a School Party That Visited a Cave in Belize: Role of Antigen Testing in Diagnosis

Imported mycoses: an update

“…Construction in endemic areas and exploration of bat-inhabited caves has sometimes caused outbreaks. 18 The total endemic area for histoplasmosis capsulati is much broader than that of coccidioidomycosis, covering tropical, subtropical, and temperate zones in the world. The biggest endemic area comprises the Mississippi and Ohio river valleys in the central part of the United States.…”

A Multinational Outbreak of Histoplasmosis Following a Biology Field Trip in the Ugandan Rainforest

“…Multiple outbreaks have been reported following travel to the Americas, frequently in association with activities such as exploring caves or reconstruction of old buildings. [7][8][9][10][11][12][13][14] In contrast, our literature search highlighted only three articles reporting a definite association of pulmonary histoplasmosis with shortterm travel to Africa in immunocompetent persons. [15][16][17] Diagnosis of histoplasmosis in returning travelers can be difficult because of its nonspecific presentation.…”

Infections associated with adventure travel: A systematic review

“…Disease has been documented after exposure to caves, cave entrances, canyoning, cleaning sites, and construction areas in North, Central and South America as well as Africa and Asia [42e47]. Cases have been documented in the following Countries after spelunking: United States [43e45], Cuba, [48], Costa Rica [49], Belize [50,51] Nicaragua [52], Guatemala, Peru [53e55], Ecuador [56], Brazil [57,58], El Salvador [59], Venezuela [60], New Caledonia [61], Cyprus [62], Martinique [63], Australia [64], and Tanzania [65].…”