Endemic mycoses: Overlooked causes of community acquired pneumonia

Hage, Chadi A.; Knox, Kenneth S.; Wheat, L. Joseph

doi:10.1016/j.rmed.2012.02.004

Cited by 78 publications

(49 citation statements)

References 72 publications

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“…Multiple diagnostic assays exist for blastomycosis and many have a low specificity due to cross-reactivity, particularly with histoplasmosis. Additionally, misdiagnosis may occur with tuberculosis, malignancy [11], [39], [40] or bacterial community acquired pneumonia [14], [41], among other conditions. However, this has been shown to differ by region since physicians in areas with higher incidence may have blastomycosis higher on their list of differential diagnoses [42].…”

Section: Discussionmentioning

confidence: 99%

Incidence and Trends of Blastomycosis-Associated Hospitalizations in the United States

et al. 2014

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We used the State Inpatient Databases from the United States Agency for Healthcare Research and Quality to provide state-specific age-adjusted blastomycosis-associated hospitalization incidence throughout the entire United States. Among the 46 states studied, states within the Mississippi and Ohio River valleys had the highest age-adjusted hospitalization incidence. Specifically, Wisconsin had the highest age-adjusted hospitalization incidence (2.9 hospitalizations per 100,000 person-years). Trends were studied in the five highest hospitalization incidence states. From 2000 to 2011, blastomycosis-associated hospitalizations increased significantly in Illinois and Kentucky with an average annual increase of 4.4% and 8.4%, respectively. Trends varied significantly by state. Overall, 64% of blastomycosis-associated hospitalizations were among men and the median age at hospitalization was 53 years. This analysis provides a complete epidemiologic description of blastomycosis-associated hospitalizations throughout the endemic area in the United States.

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Section: Discussionmentioning

confidence: 99%

Incidence and Trends of Blastomycosis-Associated Hospitalizations in the United States

et al. 2014

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“…In the majority of otherwise healthy individuals, low-dose inoculation results in a self-limiting disease with the onset of cellmediated immunity. With higher doses, Histoplasma causes acute disease, even in immunocompetent individuals (10,11).…”

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Quantitative Microplate-Based Growth Assay for Determination of Antifungal Susceptibility of Histoplasma capsulatum Yeasts

2015

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bStandardized methodologies for determining the antifungal susceptibility of fungal pathogens is central to the clinical management of invasive fungal disease. Yeast-form fungi can be tested using broth macrodilution and microdilution assays. Reference procedures exist for Candida species and Cryptococcus yeasts; however, no standardized methods have been developed for testing the antifungal susceptibility of yeast forms of the dimorphic systemic fungal pathogens. For the dimorphic fungal pathogen Histoplasma capsulatum, susceptibility to echinocandins differs for the yeast and the filamentous forms, which highlights the need to employ Histoplasma yeasts, not hyphae, in antifungal susceptibility tests. To address this, we developed and optimized methodology for the 96-well microtiter plate-based measurement of Histoplasma yeast growth in vitro. Using optical density, the assay is quantitative for fungal growth with a dynamic range greater than 30-fold. Concentration and assay reaction time parameters were also optimized for colorimetric (MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] reduction) and fluorescent (resazurin reduction) indicators of fungal vitality. We employed this microtiter-based assay to determine the antifungal susceptibility patterns of multiple clinical isolates of Histoplasma representing different phylogenetic groups. This methodology fulfills a critical need for the ability to monitor the effectiveness of antifungals on Histoplasma yeasts, the morphological form present in mammalian hosts and, thus, the form most relevant to disease.T he increasing incidence of fungal disease necessitates adequate and timely assessment of antifungal susceptibility to guide the selection and implementation of antifungal therapies. Consequently, the Clinical and Laboratory Standards Institute (CLSI) and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) have established reference test methods for susceptibility to the major classes of antifungals, which include the polyenes, azoles, and the recently developed echinocandins (1, 2). These standards utilize broth macrodilution or microdilution assays for testing yeasts (M27-A3 [3] and E.DEF 7.1 [4]) and filamentous fungi (M38-A2 [5] and E.DEF 9.1 [6]). Procedures, including inoculum preparation, media, assay duration, and endpoint definitions, have now been established for testing some of the more commonly encountered yeast-form pathogenic fungi (i.e., Candida species and Cryptococcus). However, notably missing from the M27-A3 and E.DEF 7.1 standards for testing of yeasts are methods for testing the yeast forms of the dimorphic fungi.The dimorphic fungi that cause systemic disease are characterized by distinct yeast and filamentous morphological states (7,8). Temperature is the principal morphology-determining factor, with yeast forms characterizing infections in mammals (9). Histoplasma capsulatum is the most common clinically encountered dimorphic fungal pathogen in the United States, with an estimated 10,000 to 20,000...

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“…В мире ежегодно регистрируется 5 -10 млн новых случаев инфицирования микозами людей [1,2]. Ими поражаются как иммунокомпетентные, так и иммунокомпрометированные лица.…”

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Problems of Vaccinal Prevention of Deep Mycoses

Lipnitskii¹,

Половец²,

Антонов³

2016

Epidemiology and Vaccine Prevention

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A literature review presents date obtained during the last years about the strategy of production and protective characteristics of different experimental vaccines against opportunistic and particularly dangerous deep mycoses. The role of T-lymphocytes of Th1 and Th17 types, interactions of CD4+T - and CD8+T-cells in the immune response and maintenance of immunologic memory after immunization with vaccines against mycoses are discussed.

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Endemic mycoses: Overlooked causes of community acquired pneumonia

Cited by 78 publications

References 72 publications

Incidence and Trends of Blastomycosis-Associated Hospitalizations in the United States

Incidence and Trends of Blastomycosis-Associated Hospitalizations in the United States

Quantitative Microplate-Based Growth Assay for Determination of Antifungal Susceptibility of Histoplasma capsulatum Yeasts

Problems of Vaccinal Prevention of Deep Mycoses

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