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Dermatol Pract Concept 2020 Jul 29;10(3):e2020054. Epub 2020 Jun 29.

Department of Pathology, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey.

Transl Gastroenterol Hepatol 2020 5;5:35. Epub 2020 Jul 5.

Department of Gastroenterology & Hepatology, University of Toledo Medical Center, Toledo, OH, USA.

Background: Immunosuppressive therapy is being increasingly used in the management of inflammatory bowel disease (IBD) which comprises of ulcerative colitis (UC) and Crohn's disease (CD). Patients on immunosuppressive therapy are at increased risk of developing opportunistic fungal infections. We conducted this analysis to describe the epidemiology of opportunistic fungal infections in this cohort. Read More

Semin Respir Crit Care Med 2020 Aug 6;41(4):522-537. Epub 2020 Jul 6.

Indiana University, School of Medicine, Pulmonary Critical Care Medicine, Thoracic Transplantation Program, Indianapolis, Indiana.

In endemic areas, dimorphic fungal infections due to , and account for up to 30% of cases of community-acquired pneumonia. Because respiratory manifestations are often indistinguishable from common bacterial causes of pneumonia, the diagnosis of pulmonary histoplasmosis, blastomycosis, and coccidioidomycosis is often delayed and associated with antibiotics overuse. In addition to being highly endemic to certain regions of North America, dimorphic fungi have global significance due to established areas of endemicity in all six inhabited continents, an increasingly interconnected world of travelers and transported goods, and a changing epidemiology as a result of global heating and anthropomorphic land utilization. Read More

Expert Rev Anti Infect Ther 2020 Jul 3. Epub 2020 Jul 3.

Dermatology service. Hospital General de México "Dr. Eduardo Liceaga".

Introduction: The global frequency of endemic mycoses has considerably increased, mainly due to environmental changes, population growth in endemic areas, and the increase in HIV-related immunosuppressed status. Among the most frequent endemic mycoses are coccidioidomycosis in semi-desert climates, and paracoccidioidomycosis, and histoplasmosis in tropical climates. The inoculum can enter the host through the airway or directly through the skin. Read More

Rev Iberoam Micol 2020 Jun 29. Epub 2020 Jun 29.

Dirección de Investigación, Hospital General de México "Dr. Eduardo Liceaga", Ciudad de México, México.

Background: Diabetes mellitus is a public health problem in Mexico, and the trend of the disease is increasing. From 2000 to 2017, 7.32 million new cases were diagnosed, with pulmonary mycoses being one of the most serious complications. Read More

Clin Med Res 2020 Jun 22. Epub 2020 Jun 22.

Integrated Research and Development Laboratory, Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI 54449.

Introduction: Blastomycosis is endemic in Wisconsin with and responsible for infections. Urine antigen testing is a non-invasive diagnostic method for blastomycosis with up to 93% test sensitivity. However, the test's sensitivity has not been evaluated with relationship to infections. Read More

Respir Med Case Rep 2020 30;30:101106. Epub 2020 May 30.

Division of Pulmonary, Critical Care and Sleep Medicine, Westchester Medical Center, Valhalla, NY, USA.

The term "endemic mycoses" refers to a group of fungi that maintains a baseline rate of infection only in certain geographical regions due to the hospitable enviormental conditions these regions offer. In the United States, , , and are the three most prevalent endemic human fungal infections. The traditional endemic regions for these pathogens are defined based on data acquired many decades ago, and case detection is subject to diagnostic delays even in classically endemic areas, a problem that is likely to be magnified in areas less familiar with these fungal infections. Read More

Am J Respir Crit Care Med 2020 Jun 9. Epub 2020 Jun 9.

University of Southern California Keck School of Medicine, 12223, Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Los Angeles, California, United States.

IDCases 2020 14;21:e00786. Epub 2020 May 14.

University of Tabouk, Tabuk, Tabuk, Saudi Arabia.

Blastomycosis is a fungal infection caused by Blastomyces dermatitidis, a dimorphic fungus endemic in the soils of the Ohio and Mississippi River Vallys, Great Lakes region, and southeastern United States. It most commonly manifests as a pulmonary infection following inhalation of spores, which causes a broad array of clinical manifestations ranging from asymptomatic infection to fulminant sepsis with acute respiratory distress syndrome and death. Extrapulmonary disease occurs in approximately 25-30% of patients following hematogenous spread from the lungs, with skin being the most common site of exytrapulmonary disease. Read More

Med Mycol Case Rep 2020 Jun 11;28:49-54. Epub 2020 Apr 11.

Department of Infectious Disease, Southern Illinois University, 701 North 1st Street, Springfield, IL, 62702, USA.

Blastomycosis is a systemic fungal infection which primarily involves the lungs but can disseminate to involve extrapulmonary sites. Current testing that exists includes sputum, urine, serum, and pathological tissue analysis. Radiological testing is often non-specific and highly variable. Read More

Med Mycol 2020 May 29. Epub 2020 May 29.

University of Tennessee, Graduate School of Medicine Knoxville, Tennessee, USA.

Blastomycosis is a local or systemic infection, caused by Blastomyces dermatitidis (B. dermatitidis) or B. gilchristii. Read More

IDCases 2020 13;20:e00812. Epub 2020 May 13.

Department of Infectious Diseases, Cook County Health and Hospital System, Chicago, IL, USA.

Cutaneous blastomycosis is the most common extrapulmonary manifestation of disseminated blastomycosis, a disease caused by , a dimorphic fungus endemic of North America. Initially, the organism enters the respiratory system by inhalation of the infectious conidia and produces an acute pulmonary infection that may eventually disseminate if it is left untreated. Blastomycosis may represent a diagnostic challenge and its definitive diagnosis requires direct visualization of the distinctive yeast or a positive fungal culture. Read More

Emerg Infect Dis 2020 Jun;26(6):1308-1310

Case reports have identified invasive fungal diseases in persons who use cannabis, and fungal contamination of cannabis has been described. In a large health insurance claims database, persons who used cannabis were 3.5 (95% CI 2. Read More

Int J Infect Dis 2020 May 1;96:187-191. Epub 2020 May 1.

Aspirus Wausau Hospital, Wausau, WI, USA.

Objectives: Diagnosing pulmonary blastomycosis (PB) requires the detection of Blastomyces dermatitidis in pulmonary secretions or tissue, which can be achieved via bronchoscopic procedures like bronchoalveolar lavage (BAL) or brush and transbronchial biopsy (TBBx). This descriptive study retrieved the data of PB that was diagnosed by bronchoscopy to define which bronchoscopic procedure produced the highest yield.

Methods: Retrospectively, all patients diagnosed with PB via bronchoscopic approach were identified. Read More

Cureus 2020 Mar 25;12(3):e7417. Epub 2020 Mar 25.

Family Medicine, Southern Illinois University School of Medicine, Springfield, USA.

Blastomycosis is an uncommon disease caused by the dimorphic fungus, Blastomyces dermatitidis, often found in endemic regions of Midwestern America. It can be found in forested, sandy soils, decaying vegetation, rotting wood near water sources, and even in bird feces. Most commonly, blastomycosis manifests as a pulmonary infection presenting as pneumonia, or in severe cases, respiratory distress syndrome (ARDS). Read More

J Comp Eff Res 2020 Jun 22;9(8):573-584. Epub 2020 Apr 22.

Department of Medical Microbiology & Immunology & the Department of Internal Medicine, Division of Infectious Diseases, University of California-Davis Medical Center; 4150 Y Street; Sacramento, CA 95817, USA.

This study evaluated burden of illness in immunocompromised patients with systemic mycoses (SM) eligible for itraconazole treatment, specifically, histoplasmosis, blastomycosis and aspergillosis. A cross-sectional study used an electronic medical record network integrating information from 30 US hospitals, including >34 million patients, to evaluate burden and healthcare resource utilization over 6 months following initiation of antifungal therapy. Symptomatic burden experienced by each of the otherwise healthy or age >65 or immunosuppressed cohorts receiving antifungal therapy for SM was comparable but significantly greater in cancer or HIV patients and transplant recipients. Read More

Emerg Infect Dis 2020 May;26(5):866-875

Blastomycosis is a systemic disease caused by Blastomyces spp. fungi. To determine its epidemiology in blastomycosis-endemic Minnesota, USA, we evaluated all cases reported to public health officials during 1999-2018. Read More

Clin Case Rep 2020 Apr 25;8(4):778-779. Epub 2020 Feb 25.

Division of Infectious Diseases Indiana University School of Medicine Indianapolis IN USA.

A painless progressive verrucous skin plaque in an endemic area should raise suspicion for blastomycosis resulting in prompt biopsy with fungal stains and culture. Skin is a common extrapulmonary site. Itraconazole is treatment of choice. Read More

Am J Med 2020 Apr 7. Epub 2020 Apr 7.

Department of Hospital Medicine, CHI St Vincent Infirmary, Little Rock, Ark.

Med Mycol 2020 Apr 3. Epub 2020 Apr 3.

Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.

Fungal infections cause substantial morbidity and mortality. However, the burden of deep fungal infections is not well described in Uganda. We aimed to estimate the burden and etiology of histologically diagnosed deep fungal infections in Uganda. Read More

Clin Infect Dis 2020 Mar 30. Epub 2020 Mar 30.

Department of Internal Medicine, Division of Critical Care Medicine, University of Manitoba, Winnipeg, MB, Canada.

Background: The outcomes of patients with severe pulmonary blastomycosis requiring mechanical ventilation (MV) is not well understood in the modern era. Limited historical case series have reported 50-90% mortality in patients with Acute Respiratory Distress Syndrome (ARDS) caused by blastomycosis. The objective of this large retrospective cohort study was to describe the risk factors and outcomes of patients with severe pulmonary blastomycosis. Read More

A A Pract 2020 Apr;14(6):e01181

Department of Anesthesiology and Perioperative Medicine.

Utilization of venoarterial extracorporeal membrane oxygenation (VA-ECMO) is expanding, but dual VA-ECMO circuits to treat cardiogenic shock with refractory hypoxemia is unreported. We describe the case of combined cardiogenic and distributive shock due to necrotizing pulmonary blastomycosis. After initial central VA-ECMO cannulation, acute respiratory distress syndrome (ARDS) with increasing shunt resulted in significant central hypoxemia due to progressive ventilation-perfusion mismatch. Read More

Pediatr Emerg Care 2020 Mar 19. Epub 2020 Mar 19.

Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI.

Blastomyces dermatitidis is a dimorphic fungus endemic to the United States and Canada. Although both Histoplasma and Blastomyces are found in similar geographic regions, Blastomyces is many times more likely to cause dissemination in the immunocompetent host, frequently involving the bone. However, given the indolent nature of this fungal infection and more prevalent bacterial etiologies of osteomyelitis, diagnosis and treatment are often significantly delayed. Read More

J Am Anim Hosp Assoc 2020 May/Jun;56(3):181. Epub 2020 Mar 17.

From Iowa State University, Ames, Iowa.

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Clin Infect Dis 2020 Mar 17. Epub 2020 Mar 17.

Department of Medicine, University of Wisconsin - Madison.

Background: Blastomyces is a dimorphic fungus that infects persons with or without underlying immunocompromise. To date, no study has compared the clinical features and outcomes of blastomycosis between immunocompromised and immunocompetent persons.

Methods: A retrospective study of adult patients with proven blastomycosis from 2004 - 2016 was conducted at the University of Wisconsin. Read More

Front Microbiol 2020 7;11:147. Epub 2020 Feb 7.

College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada.

Invasive fungal infections (IFI) cause devastating morbidity and mortality, with the number of IFIs more than tripling since 1979. Our laboratories were the first to demonstrate that radiolabeled microorganism-specific monoclonal antibodies are highly effective for treatment of experimental fungal, bacterial and viral infections. Later we proposed to utilize surface expressed pan-antigens shared by major IFI-causing pathogens such as beta-glucans as RIT targets. Read More

JAAD Case Rep 2020 Mar 12;6(3):169-171. Epub 2020 Feb 12.

Integrated Research and Development Laboratory, Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, Wisconsin.

BMJ Case Rep 2020 Feb 13;13(2). Epub 2020 Feb 13.

Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.

JAAD Case Rep 2020 Feb 17;6(2):96-98. Epub 2020 Jan 17.

University of Michigan, Department of Dermatology, Ann Arbor, Michigan.

Mycopathologia 2020 Feb 10. Epub 2020 Feb 10.

Division of Infectious Diseases, Department of Internal Medicine, University of Kansas, Kansas City, KS, USA.

Endemic mycoses such as histoplasmosis, coccidioidomycosis, blastomycosis, paracoccidioidomycosis, and talaromycosis are well-known causes of focal and systemic disease within specific geographic areas of known endemicity. However, over the past few decades, there have been increasingly frequent reports of infections due to endemic fungi in areas previously thought to be "non-endemic." There are numerous potential reasons for this shift such as increased use of immune suppressive medications, improved diagnostic tests, increased disease recognition, and global factors such as migration, increased travel, and climate change. Read More

Semin Respir Crit Care Med 2020 02 30;41(1):31-41. Epub 2020 Jan 30.

Infectious Diseases Division, Veterans Affairs Ann Arbor Healthcare System, University of Michigan Medical School, Ann Arbor, Michigan.

Blastomycosis is a serious fungal disease of humans and other mammals caused by environmentally acquired infection with geographically restricted, thermally dimorphic fungi belonging to the genus . The genetic and geographic diversity of these pathogens is greater than previously appreciated. In addition to and the cryptic species , which cause blastomycosis in mid-western and various eastern areas of North America, atypical blastomycosis is occasionally caused by in western parts of North America and in Africa. Read More

Cutis 2019 Dec;104(6):E18-E21

Dermatology and Laser Group of Irvine, California, and is affiliated with Hoag Hospital Irvine, California, USA.

Blastomycosis is a subacute or chronic deep mycosis caused by a dimorphic fungus, Blastomyces dermatitidis, that generally produces a pulmonary form of the disease and, to a lesser extent, extrapulmonary forms, such as cutaneous, osteoarticular, and genitourinary. Both immunocompetent and immunocompromised individuals can be infected, but more severe disease occurs in the immunocompromised. Blastomycosis can be diagnosed by culture, direct visualization of the yeast in affected tissue, antigen testing, or a combination of these methods. Read More

Am J Med 2020 Jul 8;133(7):e378-e379. Epub 2020 Jan 8.

Division of Infectious Diseases, Mayo Clinic, Rochester, Minn; Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn.

J Clin Microbiol 2020 Feb 24;58(3). Epub 2020 Feb 24.

National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa.

We reevaluated 20 cases of blastomycosis diagnosed in South Africa between 1967 and 2014, with considered to be the etiological agent, in light of newly described species and the use of more advanced technologies. In addition to histopathological and/or culture-based methods, all 20 isolates were phenotypically and genotypically characterized, including multilocus typing of five genes and whole-genome sequencing. Antifungal susceptibility testing was performed as outlined by Clinical and Laboratory Standards Institute documents M27-A3 and M38-A2. Read More

J Clin Microbiol 2019 12 23;58(1). Epub 2019 Dec 23.

Department of Laboratory Medicine and Pathology, Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, USA

Chin Med J (Engl) 2019 Dec;132(24):3006-3008

Respiratory Department, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310002, China.

Skinmed 2019;17(5):341-343. Epub 2019 Sep 1.

Department of Dermatology and Pathology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

Pharmacotherapy 2020 01 13;40(1):89-95. Epub 2019 Dec 13.

Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota.

Drug pharmacokinetics may be significantly altered in patients receiving extracorporeal membrane oxygenation (ECMO). Ensuring the optimized effective dosing of antimicrobials on ECMO remains a challenge. To date, limited data are available regarding the optimal use of amphotericin and triazoles during ECMO. Read More

Med Mycol 2020 Jul;58(5):609-616

Department of Small Animal Clinical Sciences, Michigan State University College of Veterinary Medicine, East Lansing, Michigan, USA.

Blastomycosis is a systemic fungal infection that most commonly affects dogs and humans. The disease is thought to be endemic in southern regions of Michigan, USA, but epidemiologic investigations have not been reported in detail for this state. The primary aims of this study were to investigate the prevalence and distribution of canine blastomycosis cases in Michigan and to identify risk factors for infection. Read More

Open Forum Infect Dis 2019 Nov 4;6(11):ofz438. Epub 2019 Oct 4.

Integrated Research and Development Laboratory, Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, Wisconsin.

Background: Dimorphic fungal infections, such as blastomycosis, cause significant morbidity and mortality. Historically, blastomycosis studies have focused on non-Hispanic whites, which limits our understanding of the clinical presentation and outcomes for patients of other races and ethnicities. We evaluated whether clinical presentation and disease severity varied across racial and ethnic groups. Read More

JAMA Otolaryngol Head Neck Surg 2019 Oct 31. Epub 2019 Oct 31.

Department of Otorhinolaryngology, Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois.

J Appl Lab Med 2019 11 26;4(3):370-382. Epub 2019 Jun 26.

Division of Laboratory and Genomic Medicine, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO;

Background: Urine antigen testing is a rapid sensitive method for detecting active infection with the endemic fungi and . Herein, we compared the performance of the MiraVista Diagnostics (MVista) urine antigen assay with the Niche Diagnostics (ND) urine antigen assay for the detection of histoplasmosis and blastomycosis.

Methods: Two hundred fifty urine samples from 234 patients previously tested by the MVista urine antigen assay as part of routine care were tested by the ND and urine antigen assays. Read More

Proc (Bayl Univ Med Cent) 2019 Oct 31;32(4):619-621. Epub 2019 Jul 31.

Department of Pulmonary, Allergy and Critical Care, University of Pittsburgh Medical CenterPittsburghPennsylvania.

is a thermally dimorphic fungus that can cause pulmonary, extrapulmonary, or disseminated infections. Though it can infect both immune-competent and immunocompromised hosts, the disease can be severe in immunocompromised hosts. Exposure to silica dust is associated with silicosis, and this is associated with impaired immunity and an increased risk of mycobacterial and fungal infections. Read More

J Clin Microbiol 2019 11 23;57(11). Epub 2019 Oct 23.

Department of Pathology, Division of Microbiology, The Johns Hopkins Hospital, Baltimore, Maryland, USA.

J Clin Microbiol 2019 11 23;57(11). Epub 2019 Oct 23.

Department of Pathology, Division of Microbiology, The Johns Hopkins Hospital, Baltimore, Maryland, USA.

Exp Clin Transplant 2020 Jun 11;18(3):410-413. Epub 2019 Oct 11.

From the Division of Respirology, Department of Medicine, University of Toronto, the Lung Transplant Program, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada; and the Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.

Lung transplant recipients are at risk of developing many kinds of lung infection, such as community-acquired, nosocomial, opportunistic, and endemic. Here, we report a young lung transplant recipient who developed blastomycosis, which had most likely occurred following eculizumab treatment for atypical hemolytic uremia syndrome. We hypothesize that the agent interfering with C5 would influence the immune response against Blastomyces species. Read More

Mycopathologia 2019 Oct 3;184(5):661-666. Epub 2019 Oct 3.

Department of Biological Sciences, Idaho State University, Pocatello, ID, USA.

Blastomycosis is a systemic fungal disease of humans and other animals produced by the thermally dimorphic fungal organism, Blastomyces dermatitidis. Recent studies have focused on the utilization of antibody and antigen detection in the development of immunoassays for the diagnosis of blastomycosis. This study was designed to evaluate four B. Read More

Neurohospitalist 2019 Oct 12;9(4):230-234. Epub 2019 Feb 12.

Division of Hospital Medicine, University of Kentucky Medical Center, Lexington, KY, USA.

Blastomycosis is a mycotic infection that typically affects the lung, but that can have dermatologic, orthopedic, genitourinary, and central nervous system manifestations. is a true human pathogen, which can produce disease in immunocompetent hosts. Risk factors for infection include residence in or travel to endemic areas and outdoor occupation, particularly those activities near open bodies of water and that disrupt soil. Read More