Emergomyces canadensis,a Dimorphic Fungus Causing Fatal Systemic Human Disease in North America

Abstract

We report 4 patients in North America with disease caused by Emergomyces canadensis, a newly proposed species of pathogenic dimorphic fungus. Affected persons were immunocompromised; lived in Saskatchewan, Colorado, and New Mexico; and had systemic disease involving blood, skin, cervix, lung, and lymph node. Two cases were fatal.

Global guidelines and initiatives from the European Confederation of Medical Mycology to improve patient care and research worldwide: New leadership is about working together

“…that cause disseminating IFD in severely immunosuppressed persons. [16][17][18][19][20] Moreover, new antifungal agents have recently become available or are being developed that warrant up-to-date guidance on optimal treatment of IFDs. [21][22][23] Finally, the increasing availability of new nucleic acid amplification assays, blood culture detection systems, lateral flow devices, as well as matrix-assisted laser desorption time of flight (MALDI-TOF) mass spectrometry for detection of medically important fungi and laboratory diagnosis of invasive mycoses warrants guidance in their use in clinical practice.…”

“…New medically important fungal pathogens continue to be reported, as exemplified by Lomentospora prolificans , or Emergomyces spp. that cause disseminating IFD in severely immunosuppressed persons . Moreover, new antifungal agents have recently become available or are being developed that warrant up‐to‐date guidance on optimal treatment of IFDs .…”

Emerging Infectious Diseases: a Review

“…Another emerging infectious disease is the dimorphic fungus, Emergomyces canadensis. Although other Emergomyces species have been discovered throughout Europe and Africa, E. canadensis was only recently discovered in North America [32]. Emergomyces was previously named "Emmonsia-like" pathogens.…”

“…Patients commonly had pneumonia as well as skin lesions. It is suspected that inhalational infection occurs and that geographic range involves central and western North America [32]. The diagnosis is made via histopathology or culture of affected tissue [33].…”

“…Limited susceptibility testing has shown susceptibility to itraconazole and amphotericin B. Treatment should follow typical guidelines for dimorphic fungal infections in immunocompromised hosts with amphotericin B for 1-2 weeks followed by itraconazole for 12 months [32].…”