Editorial

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3 pages, 188 KiB

Open AccessEditorial

Endemic Mycoses: Novel Findings for the Clinician

by Alessandro C. Pasqualotto

J. Fungi 2022, 8(11), 1184; https://doi.org/10.3390/jof8111184 - 10 Nov 2022

Viewed by 1142

Endemic mycoses are difficult-to-diagnose conditions that may mimic several other diseases, particularly tuberculosis, community-acquired pneumonia, and cancer [...] Full article

(This article belongs to the Special Issue Endemic Mycoses: Recent Advances in Epidemiology, Diagnosis and Treatment)

Review

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18 pages, 1887 KiB

Open AccessReview

Sporothrix brasiliensis Causing Atypical Sporotrichosis in Brazil: A Systematic Review

by Vanice Rodrigues Poester, Melissa Orzechowski Xavier, Lívia Silveira Munhoz, Rossana Patricia Basso, Rosely Maria Zancopé-Oliveira, Dayvison Francis Saraiva Freitas and Alessandro Comarú Pasqualotto

J. Fungi 2024, 10(4), 287; https://doi.org/10.3390/jof10040287 - 13 Apr 2024

Viewed by 347

Abstract

Zoonotic sporotrichosis, a subcutaneous mycosis caused by Sporothrix brasiliensis, has become hyperendemic and a serious public health issue in Brazil and an emerging disease throughout the world. Typical sporotrichosis is defined as fixed or lymphocutaneous lesion development, however, reports of atypical presentations [...] Read more.

Zoonotic sporotrichosis, a subcutaneous mycosis caused by Sporothrix brasiliensis, has become hyperendemic and a serious public health issue in Brazil and an emerging disease throughout the world. Typical sporotrichosis is defined as fixed or lymphocutaneous lesion development, however, reports of atypical presentations have been described in hyperendemic areas, which may result in a worse prognosis. Thus, considering an increase in atypical cases and in more severe extracutaneous cases and hospitalizations reported in Brazil, we aimed to perform a systematic review to search for hypersensitivity reactions (HRs) and extracutaneous presentations associated with zoonotic sporotrichosis. A systematic review was performed, following the PRISMA guidelines to search for atypical/extracutaneous cases (mucosal, osteoarthritis, HRs, pulmonary, meningeal) of zoonotic sporotrichosis. A total of 791 published cases over 26 years (1998–2023) in eleven Brazilian states were reviewed. Most cases corresponded to a HR (47%; n = 370), followed by mucosal (32%; n = 256), multifocal (8%; n = 60), osteoarthritis (7%; n = 59), meningeal (4%; n = 32), and pulmonary (2%; n = 14) infections. When available (n = 607), the outcome was death in 7% (n = 43) of cases. Here, we show a frequent and worrisome scenario of zoonotic sporotrichosis in Brazil, with a high and dispersed incidence of atypical/extracutaneous cases throughout the Brazilian territory. Therefore, educational measures are necessary to make health professionals and the overall population aware of this fungal pathogen in Brazil as well as in other countries in the Americas. Full article

(This article belongs to the Special Issue Endemic Mycoses: Recent Advances in Epidemiology, Diagnosis and Treatment)

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16 pages, 775 KiB

Open AccessReview

Molecular Diagnosis of Endemic Mycoses

by Clara Valero, María Teresa Martín-Gómez and María José Buitrago

J. Fungi 2023, 9(1), 59; https://doi.org/10.3390/jof9010059 - 30 Dec 2022

Cited by 1 | Viewed by 2127

Abstract

Diagnosis of endemic mycoses is still challenging. The moderated availability of reliable diagnostic methods, the lack of clinical suspicion out of endemic areas and the limitations of conventional techniques result in a late diagnosis that, in turn, delays the implementation of the correct [...] Read more.

Diagnosis of endemic mycoses is still challenging. The moderated availability of reliable diagnostic methods, the lack of clinical suspicion out of endemic areas and the limitations of conventional techniques result in a late diagnosis that, in turn, delays the implementation of the correct antifungal therapy. In recent years, molecular methods have emerged as promising tools for the rapid diagnosis of endemic mycoses. However, the absence of a consensus among laboratories and the reduced availability of commercial tests compromises the diagnostic effectiveness of these methods. In this review, we summarize the advantages and limitations of molecular methods for the diagnosis of endemic mycoses. Full article

(This article belongs to the Special Issue Endemic Mycoses: Recent Advances in Epidemiology, Diagnosis and Treatment)

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16 pages, 932 KiB

Open AccessReview

What’s New in Cryptococcus gattii: From Bench to Bedside and Beyond

by Justin Beardsley, Aiken Dao, Caitlin Keighley, Katherine Garnham, Catriona Halliday, Sharon C.-A. Chen and Tania C. Sorrell

J. Fungi 2023, 9(1), 41; https://doi.org/10.3390/jof9010041 - 27 Dec 2022

Cited by 7 | Viewed by 2863

Abstract

Cryptococcus species are a major cause of life-threatening infections in immunocompromised and immunocompetent hosts. While most disease is caused by Cryptococcus neoformans, Cryptococcus gattii, a genotypically and phenotypically distinct species, is responsible for 11–33% of global cases of cryptococcosis. Despite best [...] Read more.

Cryptococcus species are a major cause of life-threatening infections in immunocompromised and immunocompetent hosts. While most disease is caused by Cryptococcus neoformans, Cryptococcus gattii, a genotypically and phenotypically distinct species, is responsible for 11–33% of global cases of cryptococcosis. Despite best treatment, C. gattii infections are associated with early mortality rates of 10–25%. The World Health Organization’s recently released Fungal Priority Pathogen List classified C. gattii as a medium-priority pathogen due to the lack of effective therapies and robust clinical and epidemiological data. This narrative review summarizes the latest research on the taxonomy, epidemiology, pathogenesis, laboratory testing, and management of C. gattii infections. Full article

(This article belongs to the Special Issue Endemic Mycoses: Recent Advances in Epidemiology, Diagnosis and Treatment)

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14 pages, 5525 KiB

Open AccessReview

Chest Imaging in Systemic Endemic Mycoses

by Célia Sousa, Edson Marchiori, Ali Youssef, Tan-Lucien Mohammed, Pratik Patel, Klaus Irion, Romulo Pasini, Alexandre Mançano, Arthur Souza, Alessandro C. Pasqualotto and Bruno Hochhegger

J. Fungi 2022, 8(11), 1132; https://doi.org/10.3390/jof8111132 - 27 Oct 2022

Cited by 6 | Viewed by 1937

Abstract

Endemic fungal infections are responsible for high rates of morbidity and mortality in certain regions of the world. The diagnosis and management remain a challenge, and the reason could be explained by the lack of disease awareness, variability of symptoms, and insidious and [...] Read more.

Endemic fungal infections are responsible for high rates of morbidity and mortality in certain regions of the world. The diagnosis and management remain a challenge, and the reason could be explained by the lack of disease awareness, variability of symptoms, and insidious and often overlooked clinical presentation. Imaging findings are nonspecific and frequently misinterpreted as other more common infectious or malignant diseases. Patient demographics and clinical and travel history are important clues that may lead to a proper diagnosis. The purpose of this paper is to review the presentation and differential diagnosis of endemic mycoses based on the most common chest imaging findings. Full article

(This article belongs to the Special Issue Endemic Mycoses: Recent Advances in Epidemiology, Diagnosis and Treatment)

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21 pages, 9370 KiB

Open AccessReview

Paracoccidioidomycosis: What We Know and What Is New in Epidemiology, Diagnosis, and Treatment

by Paulo Mendes Peçanha, Paula Massaroni Peçanha-Pietrobom, Tânia Regina Grão-Velloso, Marcos Rosa Júnior, Aloísio Falqueto and Sarah Santos Gonçalves

J. Fungi 2022, 8(10), 1098; https://doi.org/10.3390/jof8101098 - 18 Oct 2022

Cited by 16 | Viewed by 4978

Abstract

Paracoccidioidomycosis (PCM) is a systemic mycosis endemic to Latin America caused by thermodimorphic fungi of the genus Paracoccidioides. In the last two decades, enhanced understanding of the phylogenetic species concept and molecular variations has led to changes in this genus’ taxonomic classification. Although [...] Read more.

Paracoccidioidomycosis (PCM) is a systemic mycosis endemic to Latin America caused by thermodimorphic fungi of the genus Paracoccidioides. In the last two decades, enhanced understanding of the phylogenetic species concept and molecular variations has led to changes in this genus’ taxonomic classification. Although the impact of the new species on clinical presentation and treatment remains unclear, they can influence diagnosis when serological methods are employed. Further, although the infection is usually acquired in rural areas, the symptoms may manifest years or decades later when the patient might be living in the city or even in another country outside the endemic region. Brazil accounts for 80% of PCM cases worldwide, and its incidence is rising in the northern part of the country (Amazon region), owing to new settlements and deforestation, whereas it is decreasing in the south, owing to agriculture mechanization and urbanization. Clusters of the acute/subacute form are also emerging in areas with major human intervention and climate change. Advances in diagnostic methods (molecular and immunological techniques and biomarkers) remain scarce, and even the reference center’s diagnostics are based mainly on direct microscopic examination. Classical imaging findings in the lungs include interstitial bilateral infiltrates, and eventually, enlargement or calcification of adrenals and intraparenchymal central nervous system lesions are also present. Besides itraconazole, cotrimoxazole, and amphotericin B, new azoles may be an alternative when the previous ones are not tolerated, although few studies have investigated their use in treating PCM. Full article

(This article belongs to the Special Issue Endemic Mycoses: Recent Advances in Epidemiology, Diagnosis and Treatment)

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26 pages, 470 KiB

Open AccessReview

Immunologic Diagnosis of Endemic Mycoses

by Rodrigo Almeida-Paes, Andrea Reis Bernardes-Engemann, Beatriz da Silva Motta, Claudia Vera Pizzini, Marcos de Abreu Almeida, Mauro de Medeiros Muniz, Renata Alves Barcelos Dias and Rosely Maria Zancopé-Oliveira

J. Fungi 2022, 8(10), 993; https://doi.org/10.3390/jof8100993 - 22 Sep 2022

Cited by 12 | Viewed by 1817

Abstract

The endemic mycoses blastomycosis, coccidioidomycosis, histoplasmosis, paracoccidioidomycosis, cryptococcosis, sporotrichosis, talaromycosis, adiaspiromycosis, and emergomycosis are mostly caused by geographically limited thermally dimorphic fungi (except for cryptococcosis), and their diagnoses can be challenging. Usual laboratory methods involved in endemic mycoses diagnosis include microscopic examination and [...] Read more.

The endemic mycoses blastomycosis, coccidioidomycosis, histoplasmosis, paracoccidioidomycosis, cryptococcosis, sporotrichosis, talaromycosis, adiaspiromycosis, and emergomycosis are mostly caused by geographically limited thermally dimorphic fungi (except for cryptococcosis), and their diagnoses can be challenging. Usual laboratory methods involved in endemic mycoses diagnosis include microscopic examination and culture of biological samples; however, serologic, histopathologic, and molecular techniques have been implemented in the last few years for the diagnosis of these mycoses since the recovery and identification of their etiologic agents is time-consuming and lacks in sensitivity. In this review, we focus on the immunologic diagnostic methods related to antibody and antigen detection since their evidence is presumptive diagnosis, and in some mycoses, such as cryptococcosis, it is definitive diagnosis. Full article

(This article belongs to the Special Issue Endemic Mycoses: Recent Advances in Epidemiology, Diagnosis and Treatment)

16 pages, 2003 KiB

Open AccessReview

Blastomycosis—Some Progress but Still Much to Learn

by Matthew F. Pullen, Jonathan D. Alpern and Nathan C. Bahr

J. Fungi 2022, 8(8), 824; https://doi.org/10.3390/jof8080824 - 07 Aug 2022

Cited by 9 | Viewed by 5467

Abstract

Blastomycosis, caused by Blastomyces spp., is an endemic mycosis capable of causing significant disease throughout the body. Higher rates of infection are seen in the Mississippi and Ohio River valleys, the Great Lakes region of the United States and Canada, much of Africa, [...] Read more.

Blastomycosis, caused by Blastomyces spp., is an endemic mycosis capable of causing significant disease throughout the body. Higher rates of infection are seen in the Mississippi and Ohio River valleys, the Great Lakes region of the United States and Canada, much of Africa, and, to a lesser extent, in India and the Middle East. Limited reporting inhibits our true understanding of the geographic distribution of blastomycosis. An estimated 50% of those infected remain asymptomatic. Of those who present with symptomatic disease, pulmonary involvement is most common, while the most common extrapulmonary sites are the skin, bones, genitourinary system, and central nervous system. Itraconazole is the standard therapy for mild–moderate disease. Data for other azoles are limited. Amphotericin is used for severe disease, and corticosteroids are occasionally used in severe disease, but evidence for this practice is limited. Despite increasing incidence and geographic reach in recent years, there are still significant knowledge gaps in our understanding of blastomycosis. Here, we provide an updated review of the epidemiology, clinical presentations, and diagnostic and therapeutic approaches for this infection. We also discuss areas needing further research. Full article

(This article belongs to the Special Issue Endemic Mycoses: Recent Advances in Epidemiology, Diagnosis and Treatment)

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32 pages, 3644 KiB

Open AccessReview

Current Progress on Epidemiology, Diagnosis, and Treatment of Sporotrichosis and Their Future Trends

by Anderson Messias Rodrigues, Sarah Santos Gonçalves, Jamile Ambrósio de Carvalho, Luana P. Borba-Santos, Sonia Rozental and Zoilo Pires de Camargo

J. Fungi 2022, 8(8), 776; https://doi.org/10.3390/jof8080776 - 26 Jul 2022

Cited by 37 | Viewed by 8059

Abstract

Sporotrichosis, a human and animal disease caused by Sporothrix species, is the most important implantation mycosis worldwide. Sporothrix taxonomy has improved in recent years, allowing important advances in diagnosis, epidemiology, and treatment. Molecular epidemiology reveals that S. brasiliensis remains highly prevalent during the [...] Read more.

Sporotrichosis, a human and animal disease caused by Sporothrix species, is the most important implantation mycosis worldwide. Sporothrix taxonomy has improved in recent years, allowing important advances in diagnosis, epidemiology, and treatment. Molecular epidemiology reveals that S. brasiliensis remains highly prevalent during the cat-transmitted sporotrichosis outbreaks in South America and that the spread of S. brasiliensis occurs through founder effects. Sporothrix globosa and S. schenckii are cosmopolitan on the move, causing major sapronoses in Asia and the Americas, respectively. In this emerging scenario, one-health approaches are required to develop a creative, effective, and sustainable response to tackle the spread of sporotrichosis. In the 21st century, it has become vital to speciate Sporothrix, and PCR is the main pillar of molecular diagnosis, aiming at the detection of the pathogen DNA from clinical samples through multiplex assays, whose sensitivity reaches remarkably three copies of the target. The treatment of sporotrichosis can be challenging, especially after the emergence of resistance to azoles and polyenes. Alternative drugs arising from discoveries or repositioning have entered the radar of basic research over the last decade and point to several molecules with antifungal potential, especially the hydrazone derivatives with great in vitro and in vivo activities. There are many promising developments for the near future, and in this review, we discuss how these trends can be applied to the Sporothrix-sporotrichosis system to mitigate the advance of an emerging and re-emerging disease. Full article

(This article belongs to the Special Issue Endemic Mycoses: Recent Advances in Epidemiology, Diagnosis and Treatment)

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16 pages, 848 KiB

Open AccessReview

Update on the Epidemiology, Diagnosis, and Treatment of Coccidioidomycosis

by Samantha L. Williams and Tom Chiller

J. Fungi 2022, 8(7), 666; https://doi.org/10.3390/jof8070666 - 25 Jun 2022

Cited by 25 | Viewed by 3845

Abstract

Coccidioidomycosis is a fungal infection caused by Coccidioides immitis and Coccidioides posadasii. The dimorphic fungi live in the soils of arid and semi-arid regions of the western United States, as well as parts of Mexico, Central America, and South America. Incidence of [...] Read more.

Coccidioidomycosis is a fungal infection caused by Coccidioides immitis and Coccidioides posadasii. The dimorphic fungi live in the soils of arid and semi-arid regions of the western United States, as well as parts of Mexico, Central America, and South America. Incidence of disease has risen consistently in recent years, and the geographic distribution of Coccidioides spp. appears to be expanding beyond previously known areas of endemicity. Climate factors are predicted to further extend the range of environments suitable for the growth and dispersal of Coccidioides species. Most infections are asymptomatic, though a small proportion result in severe or life-threatening forms of disease. Primary pulmonary coccidioidomycosis is commonly mistaken for community-acquired pneumonia, often leading to inappropriate antibacterial treatment and unnecessary healthcare costs. Diagnosis of coccidioidomycosis is challenging and often relies on clinician suspicion to pursue laboratory testing. Advancements in diagnostic tools and antifungal therapy developments seek to improve the early detection and effective management of infection. This review will highlight recent updates and summarize the current understanding of the epidemiology, diagnosis, and treatment of coccidioidomycosis. Full article

(This article belongs to the Special Issue Endemic Mycoses: Recent Advances in Epidemiology, Diagnosis and Treatment)

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10 pages, 791 KiB

Open AccessReview

Lobomycosis Epidemiology and Management: The Quest for a Cure for the Most Neglected of Neglected Tropical Diseases

by Franciely G. Gonçalves, Patrícia S. Rosa, Andrea de F. F. Belone, Léia B. Carneiro, Vania L. Q. de Barros, Rosineide F. Bispo, Yally A. da S. Sbardelott, Sebastião A. V. M. Neves, Amy Y. Vittor, William J. Woods and Gabriel Z. Laporta

J. Fungi 2022, 8(5), 494; https://doi.org/10.3390/jof8050494 - 10 May 2022

Cited by 7 | Viewed by 4306

Abstract

Lobomycosis is a chronic disease caused by Lacazia loboi, which is endemic to the Amazon rainforest, where it affects forest dwellers in Brazil. There is no disease control program and no official therapeutic protocol. This situation contributes to an unknown disease prevalence [...] Read more.

Lobomycosis is a chronic disease caused by Lacazia loboi, which is endemic to the Amazon rainforest, where it affects forest dwellers in Brazil. There is no disease control program and no official therapeutic protocol. This situation contributes to an unknown disease prevalence and unmet needs of people disabled by this disease who seek access to treatment. This review provides an update on the subject with an emphasis on therapeutic advances in humans. All relevant studies that addressed epidemiology, diagnosis, or therapeutics of lobomycosis were considered. Seventy-one articles published between 1931 and 2021 were included for a narrative literature review on the epidemiology and quest for a cure. An effective therapy for lobomycosis has been found following decades of research led by the State Dermatology Program of Acre in the Amazon rainforest, where the largest number of cases occur. This discovery opened new avenues for future studies. The main recommendations here, addressed to the Brazilian Ministry of Health, are for lobomycosis to become a reportable disease to ensure that disease prevalence is measured, and that it be prioritized such that affected individuals may access treatment free-of-charge. Full article

(This article belongs to the Special Issue Endemic Mycoses: Recent Advances in Epidemiology, Diagnosis and Treatment)

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