10 : Travel-Associated Fungal Infections

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Endemic mycoses have a restricted geographic distribution, being largely confined to areas of the world where the etiologic agents are found in nature. In recent years, however, increased domestic and international travel has led to a rise in the number of reported outbreaks and sporadic cases of histoplasmosis and coccidioidomycosis among individuals who normally reside in places far from the areas where these diseases are endemic. Recent outbreak reports have served to heighten the awareness of fungal infections among returning travelers by health care providers. This chapter focuses on fungal infections acquired during recent travel abroad rather than migration-related infections. All diagnostic tests for histoplasmosis require cautious interpretation, because cross-reactivity can occur with other endemic mycoses, such as blastomycosis and coccidioidomycosis, and prior infection or residence in an area of endemicity can result in the presence of low titers of antibody to . The diagnosis of acute pulmonary coccidioidomycosis can be made by direct microscopic examination of lower respiratory tract specimens for spherules or by culture of such specimens. The most common clinical features of penicilliosis include fever, marked weight loss, nonproductive cough, lymphadenopathy, hepatosplenomegaly, and anemia. Culture is important because other fungal infections, such as histoplasmosis and cryptococcosis, may have similar clinical manifestations in immunocompromised persons. colonies produce a distinctive red pigment which diffuses into the agar. Amphotericin B is the drug of choice for the treatment of severe cases of infection.

Citation: Hajjeh, R, Warnock D. 2004. Travel-Associated Fungal Infections, p 133-142. In Scheld W, Murray B, Hughes J (ed), Emerging Infections 6. ASM Press, Washington, DC. doi: 10.1128/9781555816995.ch10
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Figure 1

Geographic distribution of (light gray) and (dark gray) infections in the Americas (subject to limitations of surveillance and reporting). Although is restricted in distribution to the Americas, infections due to have been reported from parts of southern and eastern Europe, parts of Africa, eastern Asia, and Australia ( ); however, these reports are usually limited to single or a few cases, often with no clear source of exposure, and no outbreaks were reported outside the Americas, which makes it very difficult to accurately map the worldwide distribution of infection with this organism.

Citation: Hajjeh, R, Warnock D. 2004. Travel-Associated Fungal Infections, p 133-142. In Scheld W, Murray B, Hughes J (ed), Emerging Infections 6. ASM Press, Washington, DC. doi: 10.1128/9781555816995.ch10
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