Universität zu Köln

Salzer, Helmut J. F., Burchard, Gerd, Cornely, Oliver A., Lange, Christoph ORCID: 0000-0002-9691-4741, Rolling, Thierry ORCID: 0000-0002-0277-5067, Schmiedel, Stefan, Libman, Michael, Capone, Domenico, Dalcolmo, Margareth P. and Heyckendorf, Jan (2018). Diagnosis and Management of Systemic Endemic Mycoses Causing Pulmonary Disease. Respiration, 96 (3). S. 283 - 302. BASEL: KARGER. ISSN 1423-0356

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Abstract

Systemic endemic mycoses cause high rates of morbidity and mortality in certain regions of the world and the real impact on global health is not well understood. Diagnosis and management remain challenging, especially in low-prevalence settings, where disease awareness is lacking. The main challenges include the variability of clinical presentation, the fastidious and slow-growing nature of the fungal pathogens, the paucity of diagnostic tests, and the lack of options and toxicity of antifungal drugs. Coccidioidomycosis and paracoccidioidomycosis are restricted to the Americas only, and while histoplasmosis and blastomycosis also occur predominantly in the Americas, these mycoses have also been reported on other continents, especially in sub-Saharan Africa. Talaromycosis is endemic in tropical and subtropical regions in South-East Asia and southern China. Systemic endemic mycoses causing pulmonary disease are usually acquired via the airborne route by inhalation of fungal spores. Infections can range from asymptomatic or mild with flu-like illnesses to severe pulmonary or disseminated diseases. Skin involvement is frequent in patients with paracoccidioidomycosis, blastomycosis, sporotrichosis, and talaromycosis and manifests as localized lesions or diffuse nodules in disseminated disease, but can also occur with other endemic mycoses. Culture and/or characteristic histopathology from clinical samples is the diagnostic standard for endemic mycoses. Immunological assays are often not available for the diagnosis of most endemic mycoses and molecular amplification methods for the detection of fungal nucleic acids are not standardized at present. The first-line treatment for mild to moderate histoplasmosis, paracoccidioidomycosis, blastomycosis, sporotrichosis, and talaromycosis is itraconazole. Severe illness is treated with amphotericin B. Patients with severe coccidioidomycosis should receive fluconazole. Treatment duration depends on the specific endemic mycosis, the severity of disease, and the immune status of the patient, ranging between 6 weeks and lifelong treatment. (C) 2018 S. Karger AG, Basel

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Salzer, Helmut J. F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Burchard, Gerd UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lange, Christoph UNSPECIFIED orcid.org/0000-0002-9691-4741 UNSPECIFIED Rolling, Thierry UNSPECIFIED orcid.org/0000-0002-0277-5067 UNSPECIFIED Schmiedel, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Libman, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Capone, Domenico UNSPECIFIED UNSPECIFIED UNSPECIFIED Dalcolmo, Margareth P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heyckendorf, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-201879
DOI:	10.1159/000489501
Journal or Publication Title:	Respiration
Volume:	96
Number:	3
Page Range:	S. 283 - 302
Date:	2018
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1423-0356
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PENICILLIUM-MARNEFFEI INFECTION; CLINICAL-PRACTICE GUIDELINES; RIO-DE-JANEIRO; HISTOPLASMA-CAPSULATUM; HIGHWAY CONSTRUCTION; 2007 UPDATE; COCCIDIOIDOMYCOSIS; OUTBREAK; SOCIETY; SPOROTRICHOSIS Multiple languages Respiratory System Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/20187