Coccidioidomycosis and histoplasmosis a review of their epidemiology and geographical distribution

Ajello, Libero

doi:10.1007/bf02051969

Cited by 44 publications

(17 citation statements)

References 35 publications

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“…Since coccidioidal infection confers very longlived dermal hypersensitivity to antigen extracts of Coccidioides, these surveys measured the prevalence of prior exposure. These surveys thus provided estimates of the distribution of Coccidioides in the southwestern portion of the United States (31,32). Additionally, some counties in the Southwest had much higher proportions of skin reactivity: skin testing of long-term residents of single counties showed that in Arizona, Maricopa County (Phoenix), Pima County (Tucson), and Pinal County had over 70% positive skin test rates, compared to 10 to 40% in surrounding counties (33,34).…”

Section: Coccidioides In the Environmentmentioning

confidence: 99%

Recent Advances in Our Understanding of the Environmental, Epidemiological, Immunological, and Clinical Dimensions of Coccidioidomycosis

et al. 2013

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SUMMARY Coccidioidomycosis is the endemic mycosis caused by the fungal pathogens Coccidioides immitis and C. posadasii . This review is a summary of the recent advances that have been made in the understanding of this pathogen, including its mycology, genetics, and niche in the environment. Updates on the epidemiology of the organism emphasize that it is a continuing, significant problem in areas of endemicity. For a variety of reasons, the number of reported coccidioidal infections has increased dramatically over the past decade. While continual improvements in the fields of organ transplantation and management of autoimmune disorders and patients with HIV have led to dilemmas with concurrent infection with coccidioidomycosis, they have also led to advances in the understanding of the human immune response to infection. There have been some advances in therapeutics with the increased use of newer azoles. Lastly, there is an overview of the ongoing search for a preventative vaccine.

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Section: Coccidioides In the Environmentmentioning

confidence: 99%

Recent Advances in Our Understanding of the Environmental, Epidemiological, Immunological, and Clinical Dimensions of Coccidioidomycosis

et al. 2013

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“…In North America, the endemic regions are in the Midwestern and Southeastern of United States (1,53,136). In Latin America, the most prevalent areas are in Venezuela, Ecuador, Brazil, Paraguay, Uruguay and Argentina (13,136,140) (Fig.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of histoplasmosis

Guimarães

Nosanchuk²,

Zancopé‐Oliveira³

2006

Braz. J. Microbiol.

172

206

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Endemic mycoses can be challenging to diagnose and accurate interpretation of laboratory data is important to ensure the most appropriate treatment for the patients. Although the definitive diagnosis of histoplasmosis (HP), one of the most frequent endemic mycoses in the world, is achieved by direct diagnosis performed by micro and/or macroscopic observation of Histoplasma capsulatum (H. capsulatum), serologic evidence of this fungal infection is important since the isolation of the etiologic agents is time-consuming and insensitive. A variety of immunoassays have been used to detect specific antibodies to H. capsulatum. The most applied technique for antibody detection is immunodiffusion with sensitivity between 70 to 100 % and specificity of 100%, depending on the clinical form. The complement fixation (CF) test, a methodology extensively used on the past, is less specific (60 to 90%). Detecting fungal antigens by immunoassays is valuable in immunocompromised individuals where such assays achieve positive predictive values of 96-98%. Most current tests in diagnostic laboratories still utilize unpurified antigenic complexes from either whole fungal cells or their culture filtrates. Emphasis has shifted, however, to clinical immunoassays using highly purified and well-characterized antigens including recombinant antigens. In this paper, we review the current conventional diagnostic tools, such as complement fixation and immunodiffusion, outline the development of novel diagnostic reagents and methods, and discuss their relative merits and disadvantages to the immunodiagnostic of this mycosis.

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“…These areas have been largely defined by clinical case prevalence, 14 isolation from soils, 15 or skin-reactivity tests to specific antigens of the dimorphic fungi. [16][17][18] Ecological aspects of soils that favor growth of the hyphal forms and/or animal or bird patterns for dispersal are thought to underlie dimorphic fungal pathogen endemicity.…”

Section: Dimorphism and Endemicitymentioning

confidence: 99%

Antifungal therapeutics for dimorphic fungal pathogens

Goughenour

Rappleye

2016

Virulence

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Dimorphic fungi cause several endemic mycoses which range from subclinical respiratory infections to life-threatening systemic disease. Pathogenic-phase cells of Histoplasma, Blastomyces, Paracoccidioides and Coccidioides escape elimination by the innate immune response with control ultimately requiring activation of cell-mediated immunity. Clinical management of disease relies primarily on antifungal compounds; however, dimorphic fungal pathogens create a number of challenges for antifungal drug therapy. In addition to the drug toxicity issues known for current antifungals, barriers to efficient drug treatment of dimorphic fungal infections include natural resistance to the echinocandins, residence of fungal cells within immune cells, the requirement for systemic delivery of drugs, prolonged treatment times, potential for latent infections, and lack of optimized standardized methodology for in vitro testing of drug susceptibilities. This review will highlight recent advances, current therapeutic options, and new compounds on the horizon for treating infections by dimorphic fungal pathogens.

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Coccidioidomycosis and histoplasmosis a review of their epidemiology and geographical distribution

Cited by 44 publications

References 35 publications

Recent Advances in Our Understanding of the Environmental, Epidemiological, Immunological, and Clinical Dimensions of Coccidioidomycosis

Recent Advances in Our Understanding of the Environmental, Epidemiological, Immunological, and Clinical Dimensions of Coccidioidomycosis

Diagnosis of histoplasmosis

Antifungal therapeutics for dimorphic fungal pathogens

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