Tropen- und Reise-assoziierte Dermatomykosen

Abstract

Besides dermatophytoses, a broad range of cutaneous infections due to yeasts and moulds may occur in subtropical and tropical countries where they can affect travellers. Not to be forgotten are endemic occurring dimorphic or biphasic fungi in countries with hot climate, which cause systemic and secondary cutaneous infections in immunosuppressed and immunocompetent people. In the tropics, the prevalence of pityriasis versicolor, caused by the lipophilic yeast Malassezia spp., is about 30-40 %, in distinct areas even 50 %. Increased hyperhidrosis under tropical conditions and simultaneously humidity congestion have to be considered as significant disposing factors for pityriasis versicolor. In tropical countries, therefore, an exacerbation of a preexisting pityriasis versicolor in travellers is not rare. Today, mostly genital yeast infections due to the new species Candida africana can be found worldwide. Due to migration from Africa this yeast pathogen has reached Germany and Europe. Eumycetomas due to mould fungi are rarely diagnosed in Europe. These deep cutaneous mould infections are only found in immigrants from African countries. The therapy of eumycetoma is protracted and often not successful. Cutaneous cryptococcoses due to the yeast species Cryptococcus neoformans and Cryptococcus gattii occur worldwide; however, they are found more frequently in the tropics. Immunosuppressed patients, especially those with HIV/AIDS, are affected by cryptococcoses. Furthermore, Cryptococcus gattii also causes infections in immunocompetent hosts in Central Africa, Australia, California, and Central America.Rarely found are infections due to dimorphic fungi after travel to countries where these fungal pathogens are endemic. In individual cases, cutaneous or lymphogenic transferred sporotrichosis due to Sporothrix schenkii can occur. Furthermore, scarcely known is secondary cutaneous coccidioidomycosis due to Coccidioides immitis after travelling to desert-like endemic regions in southwestern states of the United States and in Latin America, where primary respiratory infection due to this biphasic fungus can be acquired. The antifungal agent itraconazole is the treatment of choice for sporotrichosis and coccidioidomycosis. Talaromyces marneffei-until recently known as Penicillium marneffei-is only found in Southeastern Asia. Mycosis due to this dimorphic fungus has to be considered as an AIDS-defining opportunistic infection. After hematogeneous spread, Talaromyces marneffei affects the skin and mucous membranes of the mouth. Amphotericin B and itraconazole can be used for therapy.

The threat of emerging and re-emerging pathogenic Sporothrix species

“…Historically, the largest human outbreak with an environmental source occurred between 1938 and 1949 at a gold mine in Witwatersrand, South Africa, where more than 3000 cases were documented in Bantu natives who were infected with Sporothrix propagules [106][107][108]. Currently, case reports on the African continent still refer to sapronotic transmission of the disease in humans [109][110][111][112][113][114], with sporadic cases of infection in animals [115].…”

Navigating the Aerosolized Frontier: A Comprehensive Review of Bioaerosol Research Post-COVID-19

“…Climatic and geographic conditions in different regions can affect the growth of bioaerosols, leading to differences in monitoring strategies. For example, due to the high humidity in the tropics, researchers and scholars may pay more attention to the monitoring of molds and fungi [119], whereas temperate regions are rich in plant species and have four distinct seasons, with spring and fall in particular being the peak time for many plants to bloom and release pollen. This seasonal variation leads to significantly higher pollen concentrations during specific time periods, posing a threat to allergy and asthma sufferers [120] and, thus, in temperate regions, researchers and scholars may be more concerned with pollen monitoring [121].…”

Clinical features of HIV positive talaromycosis marneffei patients and development of a risk prediction model

“…Common clinical manifestations of disseminated T. marneffei include fever, respiratory signs, anaemia, weight loss, skin lesions, lymphadenopathy, and hepatosplenomegaly. As overseas travel increases along with the use of chemotherapy and immunosuppression, TSM has become a global clinical challenge by spreading to nonendemic areas [ 5 , 6 ]. However, in recent years, there have been increasing reports of cases among non-HIV-infected patients [ 7 ].…”