Endemic mycoses: epidemiology and diagnostic strategies

Expert Rev Anti Infect Ther. 2020 Nov;18(11):1105-1117. doi: 10.1080/14787210.2020.1792774. Epub 2020 Jul 20.

Abstract

Introduction: The global frequency of endemic mycoses has considerably increased, mainly due to environmental changes, population growth in endemic areas, and the increase in HIV-related immunosuppressed status. Among the most frequent endemic mycoses are coccidioidomycosis in semi-desert climates, and paracoccidioidomycosis, and histoplasmosis in tropical climates. The inoculum can enter the host through the airway or directly through the skin. Lymphatic and hematogenous spread may involve the skin.

Areas covered: In this article, we provide up-to-date epidemiological and diagnostic data on major (histoplasmosis, paracoccidioidomycosis, coccidioidomycosis, blastomycosis) and minor (talaromycosis, adiaspiromycosis, emergomycosis) endemic mycoses.

Expert opinion: Endemic mycoses include diseases with a localized endemic area, and a few of them converge. These mycoses all have in common the airway involvement and can cause pulmonary symptoms following initial asymptomatic infection. Among the risk groups to acquire these mycoses are travelers from endemic areas, archeologists, speleologists, and immigrants. Promising and useful diagnostic tools have been developed in endemic mycoses; however, most of them are not standardized or available in low-income countries.

Keywords: Endemic mycosis; blastomycosis; coccidioidomycosis; histoplasmosis; paracoccidioidomycosis.

Publication types

  • Review

MeSH terms

  • Animals
  • Endemic Diseases / statistics & numerical data*
  • Fungi / isolation & purification
  • Global Health*
  • Humans
  • Immunocompromised Host
  • Mycoses / diagnosis
  • Mycoses / epidemiology*
  • Mycoses / microbiology
  • Risk Factors