North American Endemic Fungal Infections

Area of Science:

• Medical Mycology
• Radiology
• Infectious Diseases

Background:

• Histoplasmosis, blastomycosis, and coccidioidomycosis are endemic fungal infections prevalent in North America.
• These infections often present as subclinical or mild pneumonia, but can cause severe or disseminated disease, particularly in immunocompromised individuals.

Purpose of the Study:

• To highlight the importance of recognizing acute and chronic imaging findings of endemic fungal infections.
• To aid radiologists in diagnosing these often-elusive conditions and managing patient care.

Main Methods:

• Review of clinical and imaging manifestations of histoplasmosis, blastomycosis, and coccidioidomycosis.
• Analysis of typical and atypical presentations in both immunocompetent and immunocompromised patients.

Main Results:

• Pneumonia is the most common clinical presentation for these fungal infections.
• Imaging findings can vary from acute (e.g., consolidation, nodules) to chronic (e.g., fibrosis, cavitation).
• Immunocompromised patients exhibit a higher propensity for disseminated disease and atypical imaging patterns.

Conclusions:

• Familiarity with the spectrum of imaging findings is crucial for radiologists.
• Accurate interpretation of imaging aids in early diagnosis, monitoring disease progression, and identifying complications of endemic North American fungal infections.