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Mapping the Geographic Distribution of Dimorphic Mycoses Using a US Commercial Insurance Database.

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Summary
This summary is machine-generated.

Dimorphic mycoses (DMs) like histoplasmosis are expanding beyond traditional areas in the US. This study found diagnoses occurring outside historical regions, suggesting broader geographic spread and the need for wider clinical suspicion.

Keywords:
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Area of Science:

  • Mycology
  • Infectious Diseases
  • Epidemiology

Background:

  • Dimorphic mycoses (DMs) including histoplasmosis, blastomycosis, and coccidioidomycosis were historically confined to specific US regions.
  • Current scientific understanding suggests these geographic boundaries are expanding, but the precise extent is unclear.

Purpose of the Study:

  • To analyze the geographic distribution of dimorphic mycoses diagnoses in the United States.
  • To determine if histoplasmosis, blastomycosis, and coccidioidomycosis diagnoses are occurring outside their established endemic areas.

Main Methods:

  • Retrospective analysis of over 21 million commercially insured individuals annually in the US from 2007-2016.
  • Utilized Merative MarketScan database and ICD-9/10 codes to identify diagnoses of histoplasmosis, coccidioidomycosis, and blastomycosis.

Main Results:

  • Over 37,000 histoplasmosis, nearly 15,000 coccidioidomycosis, and over 2,000 blastomycosis cases were diagnosed across 387 Metropolitan Statistical Areas between 2007-2016.
  • Dimorphic mycoses were consistently diagnosed in areas outside their historical hyperendemic regions.

Conclusions:

  • New diagnoses of histoplasmosis, coccidioidomycosis, and blastomycosis are regularly identified beyond their historically defined endemic zones.
  • Clinicians should consider testing for DMs in patients with compatible symptoms, irrespective of geographic history, to improve diagnosis and patient outcomes.