Histoplasmosis infections worldwide: thinking outside of the Ohio River valley.
In the United States, histoplasmosis is generally thought to occur mainly in the Ohio and Mississippi River Valleys, and the classic map of histoplasmosis distribution reflecting this is second nature to many U.S. physicians. With the advent of the HIV pandemic reports of patients with progressive disseminated histoplasmosis and AIDS came from regions of known endemicity, as well as from regions not thought to be endemic for histoplasmosis throughout the world. In addition, our expanding armamentarium of immunosuppressive medications and biologics has increased the diagnosis of histoplasmosis worldwide. While our knowledge of areas in which histoplasmosis is endemic has improved, it is still incomplete. Our contention is that physicians should considerhistoplasmosiswith the right constellations of symptoms in any febrile patient with immune suppression, regardless of geographic location or travel history.
Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA ; Department of Medicine, University of Minnesota, Minneapolis MN, USA.
Nathan C
NC
Bahr
Department of Clinical and Biomedical Sciences, "Luigi Sacco," III Division of Infectious Diseases, University of Milano, Milano, Italy.
Spinello
S
Antinori
MiraVista Diagnostics, Indiapolis, IN, USA.
L Joseph
LJ
Wheat
Department of Medicine, University of Minnesota, Minneapolis MN, USA ; Department of Medicine, Minneapolis Veterans Affairs Medical Center, Minneapolis MN, USA.
George A
GA
Sarosi
Acquired Immunodeficiency Syndrome; H. capsulatum var. duboisii; Histoplasma capsulatum var. capsulatum; Histoplasmosis; Human Immunodeficiency Virus; biologic drugs; emerging; immunosuppression; infectious diseases; progressive disseminated histoplasmosis; pulmonary fungal infections; travelers