Clinical Testing Guidance for Coccidioidomycosis, Histoplasmosis, and Blastomycosis in Patients with Community-Acquired Pneumonia for Primary and Urgent Care Providers

Dallas J Smith; Rebecca J Free; George R Thompson Iii; John W Baddley; Peter G Pappas; Kaitlin Benedict; Jeremy A W Gold; Endemic Mycoses Diagnostic Algorithm Subject Matter Expert Group; Lisa A Tushla; Tom Chiller; Brendan R Jackson; Mitsuru Toda

doi:10.1093/cid/ciad619

Clinical Testing Guidance for Coccidioidomycosis, Histoplasmosis, and Blastomycosis in Patients with Community-Acquired Pneumonia for Primary and Urgent Care Providers

Clin Infect Dis. 2023 Oct 6:ciad619. doi: 10.1093/cid/ciad619. Online ahead of print.

Collaborators

Endemic Mycoses Diagnostic Algorithm Subject Matter Expert Group:
David Andes, Robert W Bradsher, Mark H Ebell, Andrej Spec, Nathan C Bahr, Carol A Kauffman, Timothy Mott, Michael Saccente, Janis E Blair, John Galgiani, Royce H Johnson, Richard Rutherford

Affiliations

¹ Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
² Mycotic Diseases Branch, Division of Foodborne, Waterborne and Environmental Diseases, Atlanta, Georgia, USA.
³ Department of Internal Medicine, Division of Infectious Diseases and the Department of Medical Microbiology and Immunology, University of California Davis Medical Center, Sacramento, California, USA.
⁴ University of California Davis Center for Valley Fever, Sacramento, California, USA.
⁵ University of Maryland School of Medicine, Baltimore, Maryland, USA.
⁶ Baltimore VA Medical Center, Baltimore, Maryland, USA.
⁷ Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA.
⁸ Terranova Medica, LLC, Colorado Springs, Colorado, USA.

PMID: 37802909
DOI: 10.1093/cid/ciad619

Abstract

Coccidioidomycosis, histoplasmosis, and blastomycosis are underrecognized and frequently misdiagnosed fungal infections that can clinically resemble bacterial and viral community-acquired pneumonia (CAP). This guidance is intended to help clinicians in outpatient settings test for these fungal diseases in patients with CAP to reduce misdiagnoses, unnecessary antibacterial use, and poor outcomes.

Keywords: blastomycosis; coccidioidomycosis; diagnostic algorithms; histoplasmosis.

Published by Oxford University Press on behalf of Infectious Diseases Society of America 2023.