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Endemic Fungi Presenting as Community-Acquired Pneumonia: A Review

Marwan M Azar1, Joshua Malo2, Chadi A Hage3

  • 1Department of Internal Medicine, Section of Infectious Diseases, School of Medicine, Yale University, New Haven, Connecticut.

Seminars in Respiratory and Critical Care Medicine
|July 7, 2020
PubMed

Insights

Dimorphic fungal infections like histoplasmosis, blastomycosis, and coccidioidomycosis cause significant community-acquired pneumonia. Delayed diagnosis and antibiotic overuse are common due to similar symptoms with bacterial pneumonia.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Pulmonology

Background:

  • Dimorphic fungi cause up to 30% of community-acquired pneumonia in endemic regions.
  • Pulmonary manifestations are often mistaken for bacterial pneumonia, leading to diagnostic delays and antibiotic overuse.
  • Global distribution and changing epidemiology due to climate change and land use increase the significance of these infections.

Purpose of the Study:

  • To review the epidemiology, pathogenesis, clinical presentation, diagnostic methods, and treatment of histoplasmosis, blastomycosis, and coccidioidomycosis.

Main Methods:

  • Literature review of endemic dimorphic fungal infections.
  • Synthesis of current knowledge on epidemiology, pathogenesis, clinical features, diagnostics, and therapeutics.

Main Results:

  • These fungal infections present diagnostic challenges due to overlapping symptoms with bacterial pneumonia.
  • Global endemicity and increasing risk factors necessitate a comprehensive understanding of these diseases.

Conclusions:

  • Accurate and timely diagnosis of histoplasmosis, blastomycosis, and coccidioidomycosis is crucial to optimize patient outcomes and reduce antibiotic misuse.
  • Understanding the evolving epidemiology and global impact of these dimorphic fungal infections is essential for public health.

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