Fungal infections: Dimorphic mycoses have spread geographically in the US according to researchers


by NewsDesk Lord, save her

Fungi in soil cause a slew of serious lung infections in 48 of the 50 states and the District of Columbia, including many areas long thought to be free of deadly environmental fungi, According to a study conducted by researchers at the University of Washington Saint Louis College of Medicine.

Studies from the 1950s and 1960s indicated that fungal lung infections were only a problem in certain parts of the country. The new study, available online in Clinical Infectious Diseases, shows that is no longer the case. Researchers said that doctors who rely on outdated maps of pathogenic fungi may miss signs of fungal infection in the lung, leading to a delayed or incorrect diagnosis.

“I get a call every few weeks from a doctor in the Boston area—a different doctor each time—about a case they can’t resolve,” said senior author Andrej Spec, MD, assistant professor of medicine who specializes in fungi. infections. “They always start out by saying, ‘We don’t have a date here, but it really sounds like histo.’ I say, ‘You call me all the time about this. You an act you have histo. “

The three main species of fungi that cause lung infections in the United States — Histoplasma (red), Blastomyces (blue) and Coccidioides (green) — have all expanded their ranges in recent decades. These maps were created based on data from 1955 (top row) and 2007-2016 (bottom row). Reliance on outdated maps may delay or miss diagnosis.
Photo/Patrick Mazey and Andre Speck/University of Washington

histoplasmaor histo, is one of the three main types of soil fungi that historically cause lung infections in the United States, histoplasma It is found in the Midwest and parts of the East. Coccidioides In the southwest, and blastomyces in the Midwest and South. But a growing number of case reports and anecdotes suggest that all three have expanded beyond their traditional ranges in recent decades, most likely due to climate change.

People develop a lung fungal infection after inhaling spores from the fungus in the soil. The spores become airborne when the ground is disrupted by farming, landscaping, construction, or even just people walking around in fungus-rich environments like caves. Most healthy adults and children can easily fight off a fungal infection, but infants, the elderly, and people with weakened immune systems may present with fever, cough, fatigue, and other symptoms. Fungal lung infections can easily be confused with bacterial or viral lung infections such as COVID-19, bacterial pneumonia, and tuberculosis.

“People with fungal lung infections often spend weeks trying to get the right diagnosis and treatment, and all the time they feel worse,” said lead author Patrick P. Mazey, MD, clinical fellow in infectious diseases. “They usually have multiple healthcare visits with multiple opportunities for testing and diagnosis, but the doctor doesn’t consider a fungal infection until they’ve exhausted all other possibilities.”

Speke, Mazey, and colleagues set out to determine where soil fungi are bothering people today. The Centers for Disease Control and Prevention (CDC) last revised its maps of pathogenic fungi in 1969.

The researchers calculated the number of fungal lung infections nationwide from 2007 to 2016 using Medicare fee-for-service claims from all 50 states and the District of Columbia. Using the patients’ home addresses to determine the counties of residence, they calculated the number of cases per 100,000 person-years for each county. (Person-years are a way to correct for the fact that counties can have very different population sizes; one person in Medicare for one year is one person-year.) Provinces caused by more than 100 cases histoplasma or Coccidioidesor 50 cases caused by blastomycesper 100,000 person-years defined as having a high number of fungal lung infections.

Of the 3,143 counties in the United States, 1,806 had a high number of pulmonary infections due to histoplasma339 of Coccidioides and 547 of blastomyces. These counties were distributed across the majority of the US Across the 50 states plus D.C., 94% have at least one county with a problem histoplasma lung infections by 69% Coccidioides and 78% with blastomyces.

“Fungal infections are more common than people realize, and they spread,” said Speck. The scientific community has underinvested in the study and development of treatments for fungal infections. I think that is starting to change, but slowly. It’s important for the medical community to recognize that these fungi are basically ubiquitous these days and that we need to take them seriously and include them in diagnostic thinking.”

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