Clinical characteristics of seven dimorphic mycoses between 2015 and 2025 using a large global database

Dimorphic mycoses are often neglected or underestimated. This study aimed to evaluate the demographic and clinical characteristics of seven dimorphic mycoses.

This retrospective study used TriNetX, a global database of multicenter electronic medical records, to evaluate the clinical characteristics of dimorphic mycoses between 2015 and 2025. The mycoses included were blastomycosis, histoplasmosis, coccidioidomycosis, paracoccidioidomycosis, talaromycosis, sporotrichosis, and lobomycosis.

The number of identified cases was as follows: blastomycosis 3711, histoplasmosis 17,895, coccidioidomycosis 6629, paracoccidioidomycosis 301, talaromycosis 345, sporotrichosis 2973, and lobomycosis 76. Patients with talaromycosis had a high prevalence of diverse medical comorbidities. All-cause mortality within 90 days of diagnosis was 5.7 % for blastomycosis, 3.1 % for histoplasmosis, 3.5 % for coccidioidomycosis, 4.7 % for paracoccidioidomycosis, and 6.1 % for talaromycosis. Mortality rates for sporotrichosis and lobomycosis could not be assessed because of the small number of deaths. All-cause hospitalization rates ranged from 15.3 % in sporotrichosis to 61.7 % in talaromycosis, whereas intensive care unit admission rates ranged from 1.0 % in sporotrichosis to 16.7 % in talaromycosis.

Critical and fatal outcomes following diagnosis of dimorphic mycoses were not uncommon, highlighting the need for strengthened preventive and therapeutic interventions. Greater attention to these neglected mycoses is necessary to reduce their global disease burden.