Fungal Infections among Returning Travelers

Abstract

Endemic mycoses, such as histoplasmosis, coccidioidomycosis, and penicilliosis, have emerged as important health threats among travelers to regions of the world where these infections are endemic. Travelers have developed fungal infections as a result of a wide range of recreational and work activities, many of which have involved well-recognized risk factors for these diseases. In some instances, infections have been acquired during short trips, whereas, in other instances, infection has been acquired during a longer period of residence in an area where the infection is endemic. Travelers need to be made aware of the risks of acquiring mycotic diseases when visiting such regions. Health care providers need to consider these infections in their differential diagnosis among returning travelers with respiratory illness and should be familiar with the treatment and prevention of these diseases.

Disseminated histoplasmosis with concurrent oral candidiasis in an Eclectus parrot (Eclectus roratus)

“…The disease has been associated with the roosting sites of various avian species including pigeons, grackles, starlings, and chickens (Schwarz et al, 1957;Ajello, 1964;Gustin & Kelley, 1971;Panackal et al, 2002;Cermeñ o et al, 2006;Loulergue et al, 2007;Valli, 2007;CDC, 2008). Since the 1950s, several cases of histoplasmosis have been reported in individuals involved in construction or cleaning activities within endemic areas containing high concentrations of bird faeces, fuelling the public health concern that birds might be carriers for the disease (Ajello, 1964;Gustin & Kelley, 1971;Panackal et al, 2002;Loulergue et al, 2007;CDC, 2008). Similar cases have also been reported in conjunction with spelunking activities in caves heavily contaminated with bat guano (Panackal et al, 2002;CDC, 2008).…”

“…Since the 1950s, several cases of histoplasmosis have been reported in individuals involved in construction or cleaning activities within endemic areas containing high concentrations of bird faeces, fuelling the public health concern that birds might be carriers for the disease (Ajello, 1964;Gustin & Kelley, 1971;Panackal et al, 2002;Loulergue et al, 2007;CDC, 2008). Similar cases have also been reported in conjunction with spelunking activities in caves heavily contaminated with bat guano (Panackal et al, 2002;CDC, 2008). Although H. capsulatum has been isolated from organs cultured in experimentally infected birds, the organism has not been successfully isolated from bird faeces, indicating that birds are not reservoir hosts or carriers of H. capsulatum (Schwarz et al, 1957;Ajello, 1964;Cermeñ o et al, 2006).…”

“…Disseminated histoplasmosis is a fungal infection caused by Histoplasma capsulatum, a zoonotic, dimorphic soil fungus endemic to the Americas and sub-Saharan Africa (Ajello, 1964;Panackal et al, 2002;Loulergue et al, 2007;Valli, 2007; Centers for Disease Control and Prevention [CDC], 2008). Outbreaks of histoplasmosis are not known to occur outside the Americas.…”

“…Outbreaks of histoplasmosis are not known to occur outside the Americas. However, numerous sporadic cases have been reported worldwide, probably due to international travel between endemic and non-endemic areas (Panackal et al, 2002;Valli, 2007;CDC, 2008). In the United States, the organism thrives in hot and humid environments and is especially prevalent in the Ohio and Mississippi river valleys (Ajello, 1964;Panakal et al, 2002;Loulergue et al, 2007;Valli, 2007;CDC, 2008).…”

Multiple brain abscesses due to Penicillium spp infection

“…Between 1991 and 1997, the University Hospital of Chiang Mai reported the occurrence of 1173 cases of systemic penicilliosis, most of them related to AIDS 20 . Nowadays, systemic penicilliosis remains one of the most common opportunistic infections on late HIV-infected patients in endemic areas, such as China, Hong Kong, Taiwan and Malasia 10,11,15,20,25 .…”