Medical mycology最新文献_第8页

Optimization of cutoff values for (1→3)-β-d-glucan and galactomannan assays in cerebrospinal fluid for the diagnosis of non-cryptococcal fungal infections of the central nervous system. 脑脊液中（1→3）-β-d-葡聚糖和半乳甘露聚糖检测诊断中枢神经系统非隐球菌真菌感染的截止值优化

IF 2.7 3区医学

Medical mycology Pub Date : 2025-04-02 DOI: 10.1093/mmy/myaf037

Arghadip Samaddar, Gregory R Kowald, Jenevi Margaret Mendonsa, Nagarathna S, Veena Kumari H B

{"title":"Optimization of cutoff values for (1→3)-β-d-glucan and galactomannan assays in cerebrospinal fluid for the diagnosis of non-cryptococcal fungal infections of the central nervous system.","authors":"Arghadip Samaddar, Gregory R Kowald, Jenevi Margaret Mendonsa, Nagarathna S, Veena Kumari H B","doi":"10.1093/mmy/myaf037","DOIUrl":"https://doi.org/10.1093/mmy/myaf037","url":null,"abstract":"Fungal infections of the central nervous system (FI-CNS) pose substantial diagnostic challenges, owing to their diverse clinical presentations and the limited sensitivity of conventional diagnostic tests. Although serum (1→3)-β-d-glucan (BDG) and galactomannan (GM) assays are FDA-approved for the diagnosis of invasive fungal infections (IFIs), their effectiveness in cerebrospinal fluid (CSF) remains underexplored, and optimal cutoff values in CSF are not well established. This study aimed to assess the utility of BDG and GM assays in CSF for diagnosing non-cryptococcal FI-CNS. We conducted a prospective observational study at the National Institute of Mental Health and Neuro Sciences in India from January 2022 to December 2023, including CSF samples from patients suspected of fungal meningitis. The cases were categorized as proven, probable, or possible FI-CNS based on the revised EORTC/MSGERC criteria. Among 61 suspected cases, 2 were proven, 48 were probable, and 11 were possible FI-CNS. The control group included 23 patients without FI-CNS suspicion. BDG and GM testing in CSF followed manufacturers' guidelines for serum. At the manufacturer's recommended cutoff of 80 pg/ml, sensitivity of BDG was 94% and specificity was 78.3%. For GM, using the manufacturer's recommended cutoff of 0.5 optical density index (ODI), sensitivity was 42% and specificity was 100%. Receiver operating characteristic curve analysis indicated optimal cutoffs of 72 pg/ml for BDG (sensitivity 96%, specificity 78.3%) and 0.47 ODI for GM (sensitivity 44%, specificity 100%). Combining both biomarkers increased sensitivity to 97.8%, suggesting that combined BDG and GM testing in CSF could significantly enhance the diagnostic accuracy and management of FI-CNS.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":"63 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

KL-6 as a predictor of coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) and mortality in critically ill COVID-19 patients: A single-center retrospective cohort study. KL-6作为2019冠状病毒病（COVID-19）相关肺曲霉病（CAPA）和危重患者死亡率的预测因子：一项单中心回顾性队列研究

IF 2.7 3区医学

Medical mycology Pub Date : 2025-04-02 DOI: 10.1093/mmy/myaf032

Hyun Kyu Cho, Si-Ho Kim, Cheon-Hoo Jeon, Jae Wan Jung, Yu Mi Wi

{"title":"KL-6 as a predictor of coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) and mortality in critically ill COVID-19 patients: A single-center retrospective cohort study.","authors":"Hyun Kyu Cho, Si-Ho Kim, Cheon-Hoo Jeon, Jae Wan Jung, Yu Mi Wi","doi":"10.1093/mmy/myaf032","DOIUrl":"10.1093/mmy/myaf032","url":null,"abstract":"This study evaluated the predictive value of Krebs von den Lungen-6 (KL-6) for the development of coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) and its association with mortality in critically ill COVID-19 patients. A retrospective single-center cohort study was conducted on critically ill COVID-19 patients who required high-flow oxygen or mechanical ventilation between January 2021 and June 2023. Serial serum KL-6 levels were measured at admission and weekly thereafter. The predictive performance of initial KL-6 was assessed using ROC curve analysis, and risk factors for CAPA and 30-day mortality were analyzed using multivariable models. Among 238 patients, 25 (10.5%) developed CAPA. Initial KL-6 demonstrated good discriminative ability for CAPA prediction (AUC 0.745; 95% CI: 0.685-0.799), with an optimal cutoff of 270.9 U/ml (sensitivity: 88.0%, specificity: 55.4%). KL-6 ≥ 270.9 U/ml remained independently associated with CAPA (aHR: 9.66; 95% CI: 2.28-40.89) after multivariable analysis. Serial measurements showed a trend toward a greater increase in KL-6 levels among CAPA patients than non-CAPA patients (median difference: 259.9 vs. 73.0 U/ml, P = .053). Additional independent predictors of CAPA included inotropic/vasopressor support, diabetes mellitus, and tocilizumab use. CAPA patients had higher all-cause 30-day mortality (60.8% vs. 45.2%; P = .020), which remained significant after adjustment (aHR: 2.19; 95% CI: 1.08-4.15). Furthermore, KL-6 was independently associated with 30-day mortality (aHR: 1.03 per 100 U/ml; 95% CI: 1.00-1.07). These findings suggest that KL-6 is a promising biomarker for predicting CAPA and mortality in critically ill COVID-19 patients.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of glycemic control on coccidioidomycosis outcomes in patients with underlying diabetes mellitus in central California. 血糖控制对加利福尼亚中部潜在糖尿病患者球孢子菌病预后的影响。

IF 2.7 3区医学

Medical mycology Pub Date : 2025-04-02 DOI: 10.1093/mmy/myaf039

Geetha Sivasubramanian, Kenneth Fox, Nam Huynh, John Woodley, Alec Chan-Golston, Seema Policepatil

{"title":"Impact of glycemic control on coccidioidomycosis outcomes in patients with underlying diabetes mellitus in central California.","authors":"Geetha Sivasubramanian, Kenneth Fox, Nam Huynh, John Woodley, Alec Chan-Golston, Seema Policepatil","doi":"10.1093/mmy/myaf039","DOIUrl":"https://doi.org/10.1093/mmy/myaf039","url":null,"abstract":"Diabetes mellitus (DM) is a known risk factor for severe coccidioidomycosis. Central California has some of the highest rates of DM in the USA, according to CDC data. This study examines the impact of glycemic control on the severity and outcomes of coccidioidomycosis in this high-DM-prevalent region. A retrospective analysis was conducted on patients with both coccidioidomycosis and DM from 2014 to 2022 at a large referral center in Fresno, California. Data collected included demographics, presentation, HbA1c levels, management, and outcomes. Fisher's exact test and the Wilcoxon-Rank sum test were used to analyze categorical and continuous measures, respectively. Logistic regression was applied for binary outcomes. We analyzed 131 patients with coccidioidomycosis and DM (62% male and 64% Hispanic). The median HbA1c at the diagnosis of coccidioidomycosis was 9%. A total of 64% developed complicated pulmonary disease, and 56% cavitary pulmonary disease. Higher HbA1c at diagnosis was associated with increased odds of complicated pulmonary disease (OR = 1.40; 95% CI: 1.05, 1.85), cavitary disease (OR = 1.43; 95% CI: 1.09, 1.88), and decreased odds of resolution (OR = 0.66; 95% CI: 0.48, 0.93). Central California, with one of the highest burdens of coccidioidomycosis, also has an increased prevalence of DM. Our study population had significantly uncontrolled DM. We also found that the level of glycemic control impacted the severity of pulmonary coccidioidomycosis and rates of resolution. Achieving reasonable glycemic control and addressing barriers to effective DM management may be just as crucial as effective antifungal therapy.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":"63 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sporothrix davidellisii : A new pathogenic species belonging to the Sporothrix pallida complex. 大卫davidellisii孢子菌：苍白孢子菌复合体中一个新的致病种。

IF 2.7 3区医学

Medical mycology Pub Date : 2025-04-02 DOI: 10.1093/mmy/myaf034

Sarah E Kidd, Marcelo Sandoval-Denis, Richard Malik, Ferry Hagen, Anderson M Rodrigues

{"title":"Sporothrix davidellisii : A new pathogenic species belonging to the Sporothrix pallida complex.","authors":"Sarah E Kidd, Marcelo Sandoval-Denis, Richard Malik, Ferry Hagen, Anderson M Rodrigues","doi":"10.1093/mmy/myaf034","DOIUrl":"https://doi.org/10.1093/mmy/myaf034","url":null,"abstract":"Sporothrix species (Ascomycota, Ophiostomatales) are dimorphic fungi with diverse ecological niches, ranging from mammalian, plant, and insect pathogens to fungicolous organisms. Here, we describe Sporothrix davidellisii (CBS 147636T), a novel pathogenic species within the S. pallida complex isolated from a case of feline sporotrichosis in Melbourne, Australia. Phylogenetic analyses based on ITS, β-tubulin (BT2), calmodulin (CAL), and translation elongation factor 1-α (EF1-α) sequences confirmed its distinctiveness, with ITS sequence identity to its closest relative (S. chilensis) not exceeding 97.6%. The assembled genome is 39.02 Mb (eight contigs) with a 27.2 kb mitochondrial genome and a total of 12,631 predicted genes. Genetic diversity analyses revealed moderate nucleotide variation in the ITS region (π = 0.055), greater diversity in BT2 (π = 0.098), and CAL (π = 0.118), supporting its status as a unique species. Morphological studies revealed distinctive characteristics differentiating S. davidellisii from its nearest relatives, including elongated clavate sympodial conidia and sessile conidia. Notably, S. davidellisii exhibits yeast-like growth at 37°C, forming ellipsoid to ovoid budding cells in liquid media, although cigar-shaped yeasts, characteristic of highly virulent Sporothrix species, are rarely observed. This ability to transition to a yeast-like form, combined with its high-temperature tolerance (growth up to 40°C), underscores its opportunistic pathogenic potential. The pathogenic role of S. davidellisii highlights the importance of monitoring atypical Sporothrix infections in feline hosts, which may serve as environmental sentinels for emerging fungal pathogens. These findings expand the taxonomy of Sporothrix, contributing to our understanding of the evolutionary complexity and zoonotic potential of species within the S. pallida complex.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":"63 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Card9 deficiency exacerbates vulvovaginal candidiasis by impairing the IL-17 production and vaginal epithelial barrier. Card9缺乏通过损害IL-17的产生和阴道上皮屏障而加剧外阴阴道念珠菌病。

IF 2.7 3区医学

Medical mycology Pub Date : 2025-04-02 DOI: 10.1093/mmy/myaf026

Wenjie Liu, Yinggai Song, Ruojun Wang, Zhe Wan, Ruoyu Li, Xiaowen Wang

引用次数: 0

Amplified fragment length polymorphism genotyping of Trichophyton indotineae indicates possible zoonotic transmission. 对 indotineae 毛癣菌的扩增片段长度多态性基因分型表明可能存在人畜共患病传播。

IF 2.7 3区医学

Medical mycology Pub Date : 2025-02-28 DOI: 10.1093/mmy/myaf020

Sheetal Thakur, Bram Spruijtenburg, Abhishek, Theun de Groot, Eelco F J Meijer, Tarun Narang, Sunil Dogra, Kamini Walia, Arunaloke Chakrabarti, Jacques F Meis, Shivaprakash M Rudramurthy

{"title":"Amplified fragment length polymorphism genotyping of Trichophyton indotineae indicates possible zoonotic transmission.","authors":"Sheetal Thakur, Bram Spruijtenburg, Abhishek, Theun de Groot, Eelco F J Meijer, Tarun Narang, Sunil Dogra, Kamini Walia, Arunaloke Chakrabarti, Jacques F Meis, Shivaprakash M Rudramurthy","doi":"10.1093/mmy/myaf020","DOIUrl":"10.1093/mmy/myaf020","url":null,"abstract":"The anthropophilic dermatophyte Trichophyton interdigitale and its counterpart T. mentagrophytes are phylogenetically closely related species. In India, the most common endemic dermatophyte species belongs to the T. indotineae. The internal transcribed spacer genotype VIII within this species complex was recently renamed as T. indotineae based on its rapid emergence in India and its elevated virulence and terbinafine resistance. While humans are considered a source of T. interdigitale infection, animals are considered a source of T. mentagrophytes. For T. indotineae it is not known whether infections occur anthropophilic or zoonotic, as there is very little data on its origin and transmission. Additionally, the environmental source of T. indotineae is unknown. In the current study, we have performed the molecular typing method amplified fragment length polymorphism on 24 T. indotineae isolates to determine the genetic diversity among animal and human origin isolates and compare it to related species. Additionally, we performed antifungal susceptibility testing by standard micro broth dilution methods against common antifungals. In contrast to the T. interdigitale which showed significant genetic variability between isolates from different cities, T. indotineae isolates demonstrate minimal genetic variability, also between samples from animals and humans, highlighting the possibility of zoonotic transmission of this virulent dermatophyte. Reduced susceptibility was found for terbinafine and griseofulvin.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of broth microdilution and Etest® methods for susceptibility testing of amphotericin B in Candida auris. 肉汤微量稀释法与est®法对耳念珠菌两性霉素B药敏试验的比较。

IF 2.7 3区医学

Medical mycology Pub Date : 2025-02-28 DOI: 10.1093/mmy/myaf019

Domenica G De Luca, Xiao Rui Li, David C Alexander, Tanis C Dingle, Philippe J Dufresne, Linda M Hoang, Julianne V Kus, Caroline Sheitoyan-Pesant, Amrita Bharat

引用次数: 0

COVID-19-associated pulmonary aspergillosis in a tertiary care center in the Midwestern Region of Brazil. 巴西中西部地区三级医疗中心的COVID-19相关肺曲霉病

IF 2.7 3区医学

Medical mycology Pub Date : 2025-02-28 DOI: 10.1093/mmy/myaf021

Marina Miranda Ely, Andyane Freitas Tetila, Anamaria Mello Miranda Paniago, Luana Rossato

{"title":"COVID-19-associated pulmonary aspergillosis in a tertiary care center in the Midwestern Region of Brazil.","authors":"Marina Miranda Ely, Andyane Freitas Tetila, Anamaria Mello Miranda Paniago, Luana Rossato","doi":"10.1093/mmy/myaf021","DOIUrl":"10.1093/mmy/myaf021","url":null,"abstract":"Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) has emerged as a complication following COVID-19 infections. This study aimed to evaluate the clinical and epidemiological data of CAPA cases in a tertiary hospital. Conducted retrospectively from February 2020 to January 2024, it involved the analysis of medical records to identify CAPA cases based on the diagnostic criteria established by the European Confederation of Medical Mycology and the International Society for Human and Animal Mycology. Seven patients were identified as possible CAPA cases, of whom 71.43% had pre-existing comorbidities. All patients received corticosteroid therapy, and 42.86% required prolonged mechanical ventilation. The study revealed a high mortality rate, with 71.43% of patients succumbing to the condition. The diagnosis of CAPA is challenging due to the invasiveness of definitive tests, such as biopsies, and the lack of resources for essential diagnostics like galactomannan detection. Despite the limited sample size, the findings align with existing literature, indicating a high prevalence of comorbidities, prior corticosteroid use, and mechanical ventilation as significant risk factors. This study underscores the critical need for heightened awareness, early diagnosis, and proactive management strategies for CAPA in severely ill COVID-19 patients to reduce risks and improve patient outcomes.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Human activity, not environmental factors, drives Scedosporium and Lomentospora distribution in Taiwan. 在台湾，人类活动而非环境因素，是影响斑孢菌和扁孢菌分布的主要因素。

IF 2.7 3区医学

Medical mycology Pub Date : 2025-02-28 DOI: 10.1093/mmy/myaf022

Hsin-Mao Wu, Yu-Hsuan Fan, Guan-Jie Phang, Wen-Ting Zeng, Khaled Abdrabo El-Sayid Abdrabo, Yu-Ting Wu, Pei-Lun Sun, Ying-Hong Lin, Yin-Tse Huang

{"title":"Human activity, not environmental factors, drives Scedosporium and Lomentospora distribution in Taiwan.","authors":"Hsin-Mao Wu, Yu-Hsuan Fan, Guan-Jie Phang, Wen-Ting Zeng, Khaled Abdrabo El-Sayid Abdrabo, Yu-Ting Wu, Pei-Lun Sun, Ying-Hong Lin, Yin-Tse Huang","doi":"10.1093/mmy/myaf022","DOIUrl":"10.1093/mmy/myaf022","url":null,"abstract":"Scedosporium and Lomentospora species are emerging fungal pathogens capable of causing severe infections in both immunocompetent and immunocompromised individuals. Previous environmental surveys have suggested potential associations between these fungi and various soil chemical parameters, though the relative influence of human activity versus environmental factors has not been systematically evaluated. Here, we conducted a comprehensive survey of 406 soil samples from 132 locations across Taiwan, analyzing fungal abundance alongside soil physicochemical parameters and the Human Footprint Index (HFI). We recovered 236 fungal isolates comprising 10 species, with S. boydii (32.2%), S. apiospermum (30.9%), and S. dehoogii (14.4%) being the most prevalent. The highest fungal burdens were observed in urban environments (up to 1293 CFU/g), particularly in public spaces and healthcare facilities. Statistical analysis revealed a significant positive correlation between fungal abundance and HFI (r = 0.143, P = .005), while soil chemical parameters including nitrogen, carbon, pH, electrical conductivity, and various base cations showed no significant associations despite their wide ranges. These findings indicate that anthropogenic disturbance of environments, rather than soil chemistry, is the primary driver of Scedosporium and Lomentospora distribution in Taiwan. This understanding holds important implications for predicting infection risks and developing targeted public health strategies, particularly in rapidly urbanizing regions. Future studies incorporating more specific indicators of human impact may further elucidate the mechanisms underlying these distribution patterns.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Histoplasmosis screening using urinary antigen detection in people living with HIV in Southern Brazil. 在巴西南部使用尿抗原检测HIV感染者的组织胞浆菌病筛查。

IF 2.7 3区医学

Medical mycology Pub Date : 2025-02-28 DOI: 10.1093/mmy/myaf017

Bianca Dos Santos Blan, Vanice Rodrigues Poester, Rossana Patricia Basso, Karine Ortiz Sanchotene, Diego H Caceres, Ivy Bastos Ramis de Souza, Alessandro C Pasqualotto, Melissa Orzechowski Xavier

{"title":"Histoplasmosis screening using urinary antigen detection in people living with HIV in Southern Brazil.","authors":"Bianca Dos Santos Blan, Vanice Rodrigues Poester, Rossana Patricia Basso, Karine Ortiz Sanchotene, Diego H Caceres, Ivy Bastos Ramis de Souza, Alessandro C Pasqualotto, Melissa Orzechowski Xavier","doi":"10.1093/mmy/myaf017","DOIUrl":"10.1093/mmy/myaf017","url":null,"abstract":"Histoplasmosis is a life-threatening opportunistic infection in individuals with advanced HIV disease, particularly in endemic regions such as Latin America. Early diagnosis is crucial for reducing mortality but remains underdiagnosed due to non-specific clinical presentations and limited diagnostic access. This study evaluates the impact of systematic histoplasmosis screening over 18 months (March 2021-September 2022) using the Histoplasma urinary antigen detection test in people living with HIV (PLHIV) receiving outpatient care or hospitalized at a reference center in Southern Brazil. A retrospective analysis was conducted on PLHIV screened with the Clarus® Histoplasma GM enzyme immunoassay (HGM-EIA, IMMY, USA). Inclusion criteria comprised a recent HIV diagnosis (≤ 30 days), poor adherence to or abandonment of antiretroviral therapy (>90 days), CD4 + count < 200 cells/mm³, or clinical/radiological findings suggestive of histoplasmosis. Clinical, laboratory, and treatment data were assessed, along with 90-day outcomes. Among 287 PLHIV screened, Histoplasma antigen was detected in 9.1% (26/287), including 19.6% of hospitalized patients and 6.4% of outpatients. Overall mortality was 24%, with a higher rate among inpatients (27.3%). Fever, neurological impairment, and lung opacification were more frequent in hospitalized cases. Amphotericin B deoxycholate was more commonly administered to inpatients (63.6% vs. 25%). Mortality at 90 days was significantly higher in patients with a histoplasmosis case-fatality score ≥ 5 (66.7% vs. 33.3%, P = .016). Systematic screening enhances early detection of histoplasmosis, facilitating timely treatment and reducing hospitalizations and mortality.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0