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Blastomycosis—Some Progress but Still Much to Learn

Blastomycosis, caused by Blastomyces spp., is an endemic mycosis capable of causing significant disease throughout the body. Higher rates of infection are seen in the Mississippi and Ohio River valleys, the Great Lakes region of the United States and Canada, much of Africa, and, to a lesser extent,...

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Autores principales: Pullen, Matthew F., Alpern, Jonathan D., Bahr, Nathan C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410313/
https://www.ncbi.nlm.nih.gov/pubmed/36012812
http://dx.doi.org/10.3390/jof8080824
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author Pullen, Matthew F.
Alpern, Jonathan D.
Bahr, Nathan C.
author_facet Pullen, Matthew F.
Alpern, Jonathan D.
Bahr, Nathan C.
author_sort Pullen, Matthew F.
collection PubMed
description Blastomycosis, caused by Blastomyces spp., is an endemic mycosis capable of causing significant disease throughout the body. Higher rates of infection are seen in the Mississippi and Ohio River valleys, the Great Lakes region of the United States and Canada, much of Africa, and, to a lesser extent, in India and the Middle East. Limited reporting inhibits our true understanding of the geographic distribution of blastomycosis. An estimated 50% of those infected remain asymptomatic. Of those who present with symptomatic disease, pulmonary involvement is most common, while the most common extrapulmonary sites are the skin, bones, genitourinary system, and central nervous system. Itraconazole is the standard therapy for mild–moderate disease. Data for other azoles are limited. Amphotericin is used for severe disease, and corticosteroids are occasionally used in severe disease, but evidence for this practice is limited. Despite increasing incidence and geographic reach in recent years, there are still significant knowledge gaps in our understanding of blastomycosis. Here, we provide an updated review of the epidemiology, clinical presentations, and diagnostic and therapeutic approaches for this infection. We also discuss areas needing further research.
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spelling pubmed-94103132022-08-26 Blastomycosis—Some Progress but Still Much to Learn Pullen, Matthew F. Alpern, Jonathan D. Bahr, Nathan C. J Fungi (Basel) Review Blastomycosis, caused by Blastomyces spp., is an endemic mycosis capable of causing significant disease throughout the body. Higher rates of infection are seen in the Mississippi and Ohio River valleys, the Great Lakes region of the United States and Canada, much of Africa, and, to a lesser extent, in India and the Middle East. Limited reporting inhibits our true understanding of the geographic distribution of blastomycosis. An estimated 50% of those infected remain asymptomatic. Of those who present with symptomatic disease, pulmonary involvement is most common, while the most common extrapulmonary sites are the skin, bones, genitourinary system, and central nervous system. Itraconazole is the standard therapy for mild–moderate disease. Data for other azoles are limited. Amphotericin is used for severe disease, and corticosteroids are occasionally used in severe disease, but evidence for this practice is limited. Despite increasing incidence and geographic reach in recent years, there are still significant knowledge gaps in our understanding of blastomycosis. Here, we provide an updated review of the epidemiology, clinical presentations, and diagnostic and therapeutic approaches for this infection. We also discuss areas needing further research. MDPI 2022-08-07 /pmc/articles/PMC9410313/ /pubmed/36012812 http://dx.doi.org/10.3390/jof8080824 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Pullen, Matthew F.
Alpern, Jonathan D.
Bahr, Nathan C.
Blastomycosis—Some Progress but Still Much to Learn
title Blastomycosis—Some Progress but Still Much to Learn
title_full Blastomycosis—Some Progress but Still Much to Learn
title_fullStr Blastomycosis—Some Progress but Still Much to Learn
title_full_unstemmed Blastomycosis—Some Progress but Still Much to Learn
title_short Blastomycosis—Some Progress but Still Much to Learn
title_sort blastomycosis—some progress but still much to learn
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410313/
https://www.ncbi.nlm.nih.gov/pubmed/36012812
http://dx.doi.org/10.3390/jof8080824
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