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Estimates of global fungal diversity have varied widely, suggesting a range from fewer than one million to over 10 million species, with each of the estimates drawing data from various criteria. In 2022, Fungal Diversity published a special issue on fungal numbers. It had been hoped that the editorial would provide a more accurate account of the numbers of fungi. Instead, it was concluded that this was not possible based on present evidence and, some of the data necessary for accurate assessments was put forward, and the present paper expands on this short article. The review first looks at estimates of fungal numbers and what these estimates are based on. It then presents future research needs that will help us to gain a more accurate estimate of fungal numbers. This includes work that needs to be done in tropical rainforests, where the greatest diversity is expected, where whole rainforests, canopy diversity, and palm fungi are addressed. Case studies for lichens and associated fungi, soil and litter fungi, evidence from particle filtration, freshwater fungi, marine fungi, mushrooms, and yeasts will also be given. Once we have such information, we can obtain a more accurate estimate of fungal numbers. [ABSTRACT FROM AUTHOR]

Fungi are one of the most diverse groups of organisms with an estimated number of species in the range of 2–3 million. The higher-level ranking of fungi has been discussed in the framework of molecular phylogenetics since Hibbett et al., and the definition and the higher ranks (e.g., phyla) of the 'true fungi' have been revised in several subsequent publications. Rapid accumulation of novel genomic data and the advancements in phylogenetics now facilitate a robust and precise foundation for the higher-level classification within the kingdom. This study provides an updated classification of the kingdom Fungi, drawing upon a comprehensive phylogenomic analysis of Holomycota, with which we outline well-supported nodes of the fungal tree and explore more contentious groupings. We accept 19 phyla of Fungi, viz. Aphelidiomycota, Ascomycota, Basidiobolomycota, Basidiomycota, Blastocladiomycota, Calcarisporiellomycota, Chytridiomycota, Entomophthoromycota, Entorrhizomycota, Glomeromycota, Kickxellomycota, Monoblepharomycota, Mortierellomycota, Mucoromycota, Neocallimastigomycota, Olpidiomycota, Rozellomycota, Sanchytriomycota, and Zoopagomycota. In the phylogenies, Caulochytriomycota resides in Chytridiomycota; thus, the former is regarded as a synonym of the latter, while Caulochytriomycetes is viewed as a class in Chytridiomycota. We provide a description of each phylum followed by its classes. A new subphylum, Sanchytriomycotina Karpov is introduced as the only subphylum in Sanchytriomycota. The subclass Pneumocystomycetidae Kirk et al. in Pneumocystomycetes, Ascomycota is invalid and thus validated. Placements of fossil fungi in phyla and classes are also discussed, providing examples. [ABSTRACT FROM AUTHOR]

Sacha inchi (Plukenetia volubilis L.) is recognized for its antioxidative properties, making it a valuable herbal source for immune modulation and treating joint and muscle pain. This study investigated the antioxidative and immunosuppressive effects of the ethanol extract of Sacha inchi leaves (EESI) in a CFA-induced rheumatoid arthritis (RA) mouse model. Swiss albino mice were assigned to experimental groups receiving EESI at 100, 200, and 300 mg/kg doses, with mobic (0.2 mg/kg) serving as the standard drug. Key parameters assessed included malondialdehyde (MDA), hydroperoxide (H2O2), total glutathione (GSH), total antioxidant capacity (TAC), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), white blood cell (WBC) count, phagocytic activity (PA), nitroblue tetrazolium (NBT) reduction, and total immunoglobulin (TI). Results indicated a significant increase in MDA and H2O2 levels in the CFA group (p < 0.05), reflecting oxidative stress due to RA. EESI treatment significantly reduced MDA and H2O2 levels in a dose-dependent manner (p < 0.05), with the 300 mg/kg dose achieving effects comparable to mobic (p > 0.05). EESI also prevented the depletion of GSH and TAC observed in CFA-induced mice (p < 0.05) and enhanced CAT, SOD, and GPx activities, suggesting improved antioxidant defenses (p < 0.05). Additionally, EESI normalized WBC count, PA, NBT reduction, and TI levels altered by CFA, particularly at the 300 mg/kg dose (p > 0.05). These findings demonstrate the potential of EESI as an effective antioxidative and immunosuppressive agent for RA management, supporting its use as an alternative therapeutic option. [ABSTRACT FROM AUTHOR]

While traditional wood preservatives may impede wood decay, their potential harm to both human health and the environment has led to limitations in their usage. This has spurred recent research to focus on seeking wood preservatives derived from plants, owing to their inherently eco-friendly attributes. Agricultural waste such as corn stover fractions, are not only abundant but also frequently underutilized, making them promising candidates for such endeavors. This study delves into the antifungal properties of extracts derived from thermally degraded corn stalk and corn cob. The selection of optimal raw materials and the identification of the most effective thermal degradation process were determined based on their inhibitory activity against Gloeophyllum trabeum (Pers.: Fr.) Murr. and Trametes versicolor (L. ex Fr.) Quél. Gas chromatography-mass spectrometry (GC-MS) was employed to analyze the composition of corn cob extracts resulting from various thermal degradation processes. The evaluation of decay resistance involved wood decay resistance tests and electron microscope observations. Results indicated that ethanol extracts from corn cobs heat-treated at 220 °C exhibited the strongest antifungal activity, accompanied by the highest extract yield. Additionally, the corn cob extracts also demonstrated inhibitory effects on the growth of Aspergillus niger, Escherichia coli, and Staphylococcus aureus. Chemical analysis revealed significant quantities of vanillin, squalene, and other compounds known for their antifungal or antibacterial activity in the corn cob extracts. Furthermore, wood treated with these extracts exhibited improved decay resistance, surpassing that against G. trabeum compared to T. versicolor. These findings suggest that thermally degraded corn cob extracts can be utilized as environmentally friendly wood preservative. [ABSTRACT FROM AUTHOR]

Ecological associations between wild felids and parasites from the Taeniidae family are related to predator–prey interactions, where felids act as definitive hosts while their prey, herbivores and/or omnivores, act as intermediate hosts. In the Atlantic Forest, six neotropical felid species coexist in sympatry, but the ecological parasite-host interactions remain poorly studied. Taenia omissa is a tapeworm that parasitizes cougars (Puma concolor) as its only definitive host and their ungulate prey as intermediate hosts. The aim of this study was to identify tapeworms present in road-killed fauna using both molecular and morphological characteristics and their predator–prey relationship. Adult tapeworms found in a cougar, a jaguarundi (Herpailurus yagouaroundi), and two ocelots (Leopardus pardalis); and metacestodes found in a red brocket deer (Mazama americana) and a wild guinea pig (Cavia aperea) were analyzed. Through morphological analysis of rostellar hooks and molecular analysis of the mitochondrial genetic marker cox1, Taenia omissa adult individuals were identified in the cougar, and metacestodes in the red brocket deer, proving the existence of a full host-parasite life cycle in the Atlantic Forest region. This new report reveals the southernmost record of T. omissa and broadens its geographic distribution. In addition, isolates of the Taenia genus divergent from those described so far in molecular databases were reported and suggested a wild cycle that involves the jaguarundi and agouti (Dasyprocta asarae) as definitive and intermediate hosts, respectively. These results highlight the complexity of the tapeworm population in the region and the need to study it with both morphological and molecular approaches. [ABSTRACT FROM AUTHOR]

Background: Filamentous fungi of the genus Madurella are the primary causative agents of mycetoma, a disease observed in tropical and subtropical regions. Since early diagnostics based on a morphological approach are difficult and have many shortcomings, a molecular diagnostic method suitable for rural settings is required. In this study, we developed the loop-mediated isothermal amplification (LAMP) method to present a foundational technique of the diagnosis of Madurella spp. (M. mycetomatis, M. pseudomycetomatis, M. tropicana, and M. fahalii), the common causative organisms of eumycetoma. Principal findings: We successfully designed a primer pair targeting the rDNAs of three Madurella spp. excluding M. fahalii, and detected up to 100 fg of genomic DNA extracted from isolates of M. mycetomatis and 1 pg of M. pseudomycetomatis and M. tropicana, within one hour. Second, a primer pair specific to M. mycetomatis, the most common causative species, or M. fahalii, a drug-resistant species, was constructed, and the detection limit of both primer pairs was 1 pg. The designed primers accurately distinguished 16 strains of the genus Madurella from various fungal species known to cause mycetomas. Conclusion: In summary, we established the first model of a LAMP detection method that rapidly and sensitively detects and identifies Madurella isolates for clinical diagnostics. Moreover, the combined designed primer sets could identify mycetoma-causing strains simultaneously. Author summary: Mycetoma is known as a neglected tropical disease causing chronic granulomatous inflammation of the subcutaneous tissue due to infection by microorganisms. In particular, a simple molecular diagnostic method for fungal mycetoma (eumycetoma) is required for a community-based medical treatment, because of the difficulty in isolating and identifying the causative fungus. In this study, we established the loop-mediated isothermal amplification (LAMP) method to identify Madurella strains which are common causative agents of eumycetoma. The results suggest that diagnosis using the LAMP reaction enables specific and sensitive detection of Madurella by incubating the sample at a constant temperature and visually confirming DNA amplification. Based on these results, we expect that the LAMP-based diagnosis will contribute to the treatment of eumycetoma in rural settings [ABSTRACT FROM AUTHOR]

Background: In‐house real‐time PCR (qPCR) is increasingly used to diagnose the so‐called endemic mycoses as commercial assays are not widely available. Objectives: To compare the performance of different molecular diagnostic assays for detecting Histoplasma capsulatum and Coccidioides spp. in five European reference laboratories. Methods: Two blinded external quality assessment (EQA) panels were sent to each laboratory that performed the analysis with their in‐house assays. Both panels included a range of concentrations of H. capsulatum (n = 7) and Coccidioides spp. (n = 6), negative control and DNA from other fungi. Four laboratories used specific qPCRs, and one laboratory a broad‐range fungal conventional PCR (cPCR) and a specific cPCR for H. capsulatum with subsequent sequencing. Results: qPCR assays were the most sensitive for the detection of H. capsulatum DNA. The lowest amount of H. capsulatum DNA detected was 1–4 fg, 0.1 pg and 10 pg for qPCRs, specific cPCR and broad‐range cPCR, respectively. False positive results occurred with high concentrations of Blastomyces dermatitidis DNA in two laboratories and with Emergomyces spp. in one laboratory. For the Coccidioides panel, the lowest amount of DNA detected was 1–16 fg by qPCRs and 10 pg with the broad‐range cPCR. One laboratory reported a false positive result by qPCR with high load of Uncinocarpus DNA. Conclusion: All five laboratories were able to correctly detect H. capsulatum and Coccidioides spp. DNA and qPCRs had a better performance than specific cPCR and broad‐range cPCR. EQAs may help standardise in‐house molecular tests for the so‐called endemic mycoses improving patient management. [ABSTRACT FROM AUTHOR]

Ophiocordyceps sinensis is a highly valued medicinal fungus and has been used as a traditional Chinese medicine (TCM) to treat asthma and respiratory, kidney, and other diseases for centuries. Due to its medical benefit and scarcity of natural resource, the anamorph mycelium is considered to be a useful substitute for natural O. sinensis. Here, the isolate mycelium from the fruit body of natural O. sinensis was identified to be the anamorph of O. sinensis using single-gene (wc-1 gene) and multi-locus sequence typing (MLST) of 3 genes (ITS, nrSSU, and β-tubulin) based molecular phylogenetic analysis. Biomass assay showed that the log phase occurred in 30–50 days of culture in media. Lots of aerial mycelium was produced on the 60-day potato dextrose agar (PDA) culture and was found to be sticky into lumps with numerous conidia under a scanning electron microscope (SEM) and an optical microscopy. Conidia were polymorphic, measuring about 1.94–5.83 × 1.58–5.57 µm in size, and could be distinguished from other filamentous fungi. Besides, the number of blastospores increased in the 30–60 day potato dextrose broth (PD) liquid culture. No conidia or blastospores were observed in the early stages in PDA media. So the mycelium would initially grow in a polar growth pattern, followed by budding growth or/and conidiogenesis in media. Moreover, some interesting and significant observations revealed that conidial and hyphal fusion occurred, which would play important roles in nutrition utilization, reproduction, and hyphal growth in this isolate. Moreover, 12 sporulation-related genes were screened using our RNA-seqs of O. sinensis, and the mRNA levels were assayed between 45-day and 90-day culture using quantitative real-time PCR(qPCR). Four of them, including fbA, skn7, abaA, and serine/threonine-protein kinase MAK gene, had higher levels of expression in the 45-day culture than in the 90-day culture. Besides, nucleoside components were detected using high-performance liquid chromatography analysis (HPLC). Our findings would aid in understanding O. sinensis's asexual reproduction and hyphal growth in media, as well as the use of the anamorph mycelium as a substitute for natural O. sinensis. [ABSTRACT FROM AUTHOR]

Paracoccidioidomycosis ( PCM) is a systemic mycosis that occurs in several Latin American countries, especially in Brazil. It is caused by the thermo-dimorphic fungus Paracoccidioides spp. Serological studies to detect animal infection represent an excellent strategy for data on the agent's ecology. Although the state of Rio Grande do Sul ( RS) is an endemic area for PCM in humans, there is scarce information available on the ecology of the agent in the region. This study aimed to investigate the infection by Paracoccidioides lutzii in animals living in RS, Brazil. A total of 85 wild mammals, 200 horses and 196 domestic dogs, previously tested for infection by P. brasiliensis, were included in this study. Serum samples from the animals were tested by ELISA to detect anti- P. lutzii antibodies. From the 481 animals tested, 105 (21.8%) were seropositive for IgG anti- P. lutzii. Of these, 54 were also positive for P. brasiliensis. A total of 11 horses (10.5%), 30 dogs (28.8%) and 10 wild mammals (9.5%) were positive only for P. lutzii (n=51). The detection of anti- P. lutzii antibodies in animals of RS suggests that the fungus can be found in southern Brazil, despite being described mainly in the midwest and southeast of the country. [ABSTRACT FROM AUTHOR]

We established and validated an improved loop-mediated isothermal amplification (LAMP) method combined with a TaqMan probe (LAMp-Taqman method) for detection of Mycoplasma gallinis (MG). A test plasmid was constructed using a conserved sequence of the specific gene vlhA of MG, and the LAMP primer set was screened according to the conservative gene design. The loop primer modified by fluorescent/quenching dyes was used as the TaqMan probe to establish the LAMP-TaqMan detection method. The feasibility and application value of LAMP in detecting MG nucleic acids were evaluated by parallel testing using real-time fluorescence quantitative qPCR as a control. The study results showed that LAMP-TaqMan had good specificity in detecting MG nucleic acids. The optimal detection temperature was 63 ºC, and the linear correlation coefficient R2 of eight tenfold serial dilutions (2.607 × 106 copies/µL–2.607 × 10−1 copies/µL) was 0.995; the minimum detection limit was 2.607–1 copies/µL, and the detection rate of the minimum detection limit was 100%. The high-, medium-, and low-concentration test plasmids were tested for repeatability (the coefficients of variation (CVs) were 0.202%, 1.770%, and 3.771%, respectively). Parallel tests were conducted on 120 samples collected from pairs of chickens, the accuracy, sensitivity and specificity of TP-LAMP were 97.50%, 100.00% and 96.30%, respectively. The detection time is 1 h, in fact, test results can be obtained in 45 min. The LAMP-TaqMan isothermal nucleic acid detection method not only maintains the effect of the loop primer to accelerate amplification but also offers fast and simple detection, a low detection limit, and a low rate of false positives; it has a broad market application prospect in the accurate and rapid detection of poultry diseases. [ABSTRACT FROM AUTHOR]

Background: Despite recognition of histoplasmosis as a disease of national public health concern in Kenya, the burden of Histoplasma capsulatum in the general population remains unknown. This study examined the human seroprevalence of anti-Histoplasma antibody and explored associations between seropositivity and demographic and environmental variables, in Busia county, western Kenya. Methodology: Biobanked serum samples and associated data, from a previous cross-sectional survey, were examined. Latex agglutination tests to detect the presence of anti-Histoplasma antibody were performed on serum samples from 670 survey respondents, representing 178 households within 102 sub-locations. Potential epidemiologic risk factors for H. capsulatum exposure were explored using multi-level multivariable logistic regression analysis with household and sub-location included as random effects. Principal findings: The apparent sample seroprevalence of anti-Histoplasma antibody was 15.5% (n = 104/670, 95% Confidence Interval (CI) 12.9–18.5%). A multivariable logistic regression model identified increased odds of H. capsulatum seropositivity in respondents reporting rats within the household within the previous 12 months (OR = 2.99 90% CI 1.04–8.55, p = 0.04). Compared to respondents aged 25–34 years, the odds of seropositivity were higher in respondents aged 15–24 years (OR = 2.70 90% CI 1.04–6.97, p = 0.04). Conclusions: The seroprevalence result provides a baseline for sample size approximations for future epidemiologic studies of the burden of H. capsulatum exposure in Busia county. The final model explored theoretically plausible risk factors for H. capsulatum exposure in the region. A number of factors may contribute to the complex epidemiological picture impacting H. capsulatum exposure status at the human-animal-environment interface in western Kenya. Focussed H. capsulatum research is warranted to determine the contextual significance of identified associations, and in representative sample populations. Author summary: Despite recognition of histoplasmosis as a priority disease of public health concern in Kenya and an important AIDS-defining illness, there remains a paucity of research on this neglected fungal disease. Clinical and laboratory capacity for the diagnosis and treatment of histoplasmosis across Kenya is limited or unknown, and existing diagnostic and therapeutic techniques can be cost-prohibitive. In addition, the fragmentary nature of histoplasmosis research groups worldwide and the under- or over-representation of specific sociodemographic groups and geographic regions in outbreak reports and hospital-based case series have been acknowledged. This study provides a first look at Histoplasma capsulatum seroprevalence in rural western Kenya and explores risk factors for exposure at this human-animal-environment interface. More broadly, these outcomes will help quantify the burden of H. capsulatum in household and community environments, which may direct further research efforts and inform policy-makers on the prioritisation for clinical services and public health efforts with regards to histoplasmosis. [ABSTRACT FROM AUTHOR]

Morphological analyses of three glomoid spore-producing fungi suggested that two of them were undescribed species of Glomeraceae (phylum Glomeromycota), and the third differed slightly from Dominikia glomerocarpica and Epigeocarpum crypticum, recently described in Glomeraceae. The first two fungi originated from the Mediterranean Sea sand dunes of the Peloponnese, Greece, and the third was originally found in a tree plantation in Yokohama City, Japan. Phylogenetic analyses of sequences of the 45S nuc rDNA region and the RPB1 gene showed that (i) the three fungi belonged to Glomeraceae; (ii) the first two represented a new genus, here described as Complexispora gen. nov. with C. multistratosa sp. nov. and C. mediterranea sp. nov. and (iii) the third enlarged the monospecific genus Epigeocarpum, as E. japonicum sp. nov. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) has released a fungal priority pathogen list (FPPL) to prioritize fungal pathogens based on their research and development needs and public health importance. The list categorizes 19 major invasive fungal pathogens into critical, high, and medium priority, with over half of them posing significant threats to respiratory patients. It is important for respiratory physicians to understand the clinical presentations, diagnostic methods, and treatment options for these infections in order to reduce morbidity and mortality. The FPPL aims to drive improvements in laboratory capacity, surveillance systems, and public health interventions to address these priority fungal pathogens. [Extracted from the article]

We present a patient referred for investigation of adrenal insufficiency, confirmed due to disseminated paracoccidioidomycosis (PCM), with abdominal and central nervous system (CNS) involvement. Establishing the pathogenesis and immunological processes involved in chronic or latent infections by PCM has been challenging. Medical doctors caring for patients with immunodeficiencies should learn about these fungal infections to properly guide travel planning and have this possibility in the diagnostic arsenal when the patient returns from endemic areas. After 13 months of treatment, the patient showed good clinical evolution, and we repeated imaging exams, showing partial improvement of the preview lesions. Diagnosis and treatment can prevent catastrophic events. [ABSTRACT FROM AUTHOR]

Paracoccidioides species have always been surrounded by taxonomic uncertainties. The continuing nomenclatoral muddle was caused in part by the failure of Adolfo Lutz and Jorge Lôbo to name the etiologic agents of human paracoccidioidomycosis and Jorge Lôbo's diseases, respectively. Early in their history, it was postulated that the cultivable species causing systemic infections belonged in the genus Paracoccidioides, whereas the uncultivable species, causing skin disease, were not part of the genus. The taxonomy of these pathogens was further complicated when a similar skin disease with numerous yeast-like cells in infected dolphins was also reported. Due to its phenotypic similarities with that described by Jorge Lôbo in human and its uncultivable nature, it was assumed that the disease in dolphins was caused by the same fungus. Recent molecular and population genetic analysis, however, found the DNA extracted from the uncultivable yeast-like cells affecting dolphins shared common phylogenetic traits with cultivable Paracoccidioides species. The study revealed that the uncultivable pathogens comprised 2 different Paracoccidioides species, now known as P. ceti and P. loboi, correspondingly. To validate P. loboi binomial, a comprehensive historical critical review of Jorge Lôbo etiology was performed. This review showed the proposed binomial P. loboi was previously used, and, thus, a replacement name is introduced, Paracoccidioides lobogeorgii nom. nov. In addition, in this review, several cultivable human Paracoccidioides species are validated, and the generic type species, P. brasiliensis, is neotypified as the original material could not be traced. [ABSTRACT FROM AUTHOR]

Background: Emerging fungal pathogens pose important threats to global public health. The World Health Organization has responded to the rising threat of traditionally neglected fungal infections by developing a Fungal Priority Pathogens List (FPPL). Taking the highest-ranked fungal pathogen in the FPPL, Cryptococcus neoformans, as a paradigm, we review progress made over the past two decades on its global burden, its clinical manifestation and management of cryptococcal infection, and its antifungal resistance. The purpose of this review is to drive research efforts to improve future diagnoses, therapies, and interventions associated with fungal infections. Methods: We first reviewed trends in the global burden of HIV-associated cryptococcal infection, mainly based on a series of systematic studies. We next conducted scoping reviews in accordance with the guidelines described in the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews using PubMed and ScienceDirect with the keyword Cryptococcus neoformans to identify case reports of cryptococcal infections published since 2000. We then reviewed recent updates on the diagnosis and antifungal treatment of cryptococcal infections. Finally, we summarized knowledge regarding the resistance and tolerance of C. neoformans to approved antifungal drugs. Results: There has been a general reduction in the estimated global burden of HIV-associated cryptococcal meningitis since 2009, probably due to improvements in highly active antiretroviral therapies. However, cryptococcal meningitis still accounts for 19% of AIDS-related deaths annually. The incidences of CM in Europe and North America and the Latin America region have increased by approximately two-fold since 2009, while other regions showed either reduced or stable numbers of cases. Unfortunately, diagnostic and treatment options for cryptococcal infections are limited, and emerging antifungal resistance exacerbates the public health burden. Conclusion: The rising threat of C. neoformans is compounded by accumulating evidence for its ability to infect immunocompetent individuals and the emergence of antifungal-resistant variants. Emphasis should be placed on further understanding the mechanisms of pathogenicity and of antifungal resistance and tolerance. The development of novel management strategies through the identification of new drug targets and the discovery and optimization of new and existing diagnostics and therapeutics are key to reducing the health burden. [ABSTRACT FROM AUTHOR]

Paracoccidioidomycosis (PCM) is a systemic mycosis caused by pathogenic dimorphic fungi of the Paracoccidioides brasiliensis complex. It is the most important systemic mycosis in Latin America, mainly in Brazil. Despite its severity and high mortality rates, it is considered a neglected disease. Species within the genus Paracoccidioides present genetics and morphological variations with probable clinical, diagnostic and therapeutic consequences. In fact, there are a very small number of detailed case reports with molecular identification of these fungal agents. Here, it is reported a case of PCM due to Paracoccidioides brasiliensis PS2. Molecular identification of the isolate was performed by amplification and sequencing of the arf and gp43 genes. Clinical cases and strain reports with molecular identification in the literature are also reviewed. The case herein presented is the first autochthonous report of PCM due to Paracoccidioides brasiliensis PS2 species in the state of Rio de Janeiro, Brazil, an important endemic area. The patient presented a chronic pulmonary form of PCM and had a satisfactory response to sulfamethoxazole/trimethoprim although sequelae such as adrenal insufficiency and dysphonia were observed. This study may contribute to improve the knowledge about this severe disease, its causative cryptic species and their consequences to patients. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 18-year-old male student presented to the hospital complaining of abdominal pain, fever and weight loss. Topics discussed include parasitological analysis of feces and chest X-ray of the patient reveals idiopathic hypereosinophilic syndrome, positive results for Ouchterlony double radial immunodiffusion test (ID) for paracoccidioidomycosis (PCM) caused by Paracoccidioides brasiliensis and an enlarged spleen from computerized tomography of the abdomen.

Background: Paracoccidioides brasiliensis and Paracoccidioides lutzii are the etiological agents of Paracoccidioidomycosis (PCM), and are easily isolated from human patients. However, due to human migration and a long latency period, clinical isolates do not reflect the spatial distribution of these pathogens. Molecular detection of P. brasiliensis and P. lutzii from soil, as well as their isolation from wild animals such as armadillos, are important for monitoring their environmental and geographical distribution. This study aimed to detect and, for the first time, evaluate the genetic diversity of P. brasiliensis and P. lutzii for Paracoccidioidomycosis in endemic and non-endemic areas of the environment, by using Nested PCR and in situ hybridization techniques. Methods/Principal Findings: Aerosol (n = 16) and soil (n = 34) samples from armadillo burrows, as well as armadillos (n = 7) were collected in endemic and non-endemic areas of PCM in the Southeastern, Midwestern and Northern regions of Brazil. Both P. brasiliensis and P. lutzii were detected in soil (67.5%) and aerosols (81%) by PCR of Internal Transcribed Spacer (ITS) region (60%), and also by in situ hybridization (83%). Fungal isolation from armadillo tissues was not possible. Sequences from both species of P. brasiliensis and P. lutzii were detected in all regions. In addition, we identified genetic Paracoccidioides variants in soil and aerosol samples which have never been reported before in clinical or armadillo samples, suggesting greater genetic variability in the environment than in vertebrate hosts. Conclusions/Significance: Data may reflect the actual occurrence of Paracoccidioides species in their saprobic habitat, despite their absence/non-detection in seven armadillos evaluated in regions with high prevalence of PCM infection by P. lutzii. These results may indicate a possible ecological difference between P. brasiliensis and P. lutzii concerning their wild hosts. [ABSTRACT FROM AUTHOR]

Paracoccidioidomycosis is an important systemic fungal infection that occurs throughout Latin America. The etiological agents comprise a species complex that includes two major groups: P. brasiliensis (including subgroups S1, PS2, and PS3) and P. lutzii. A great number of phenotypes may overlap, especially among closely related groups, discouraging the use of morphology alone for species recognition. To overcome this problem, here we propose identifying cryptic Paracoccidioides spp. using polymerase chain reactionrestriction fragment length polymorphism (PCR-RFLP) of the alpha-tubulin (TUB1) gene. In silico analysis of 90 TUB1 sequences led to the identification of two restriction enzymes with the potential to identify Paracoccidioides: Bcl I and MspI. A portion of the TUB1 gene was amplified and double digested in vitro with the Bcl I and MspI endonucleases, which generated four different electrophoretic patterns corresponding to the four main genetic groups: S1, PS2, and PS3 of P. brasiliensis and P. lutzii. The major P. brasiliensis group recognized was S1 (n = 17; 42.5%), followed by PS2 (n = 9; 22.5%) and PS3 (n = 6; 15%). A total of eight (20%) P. lutzii isolates were identified, mainly from midwestern Brazil. Our data revealed that TUB1-RFLP is an efficient, fast, and inexpensive tool for identifying Paracoccidioides spp., which may be directly applied to the molecular epidemiological studies of paracoccidioidomycosis. [ABSTRACT FROM AUTHOR]

The harvest of meat from wild animals is essential for the nutrition of many human populations in the Neotropics. Specific techniques are used to access wild meat in this region, but collecting meat from road killed animals, or purposely run over animals to kill and consume the meat have not been documented so far. In this study we interviewed four residents of the state of Rondônia who claimed to consume roadkilled animals. Respondents cited only medium and large mammals (10 species in total) as the group from which wild meat is harvested, with one respondent claiming to intentionally run over the animals. The interviewees analyse the smell/putrefaction condition, swelling and exposure of viscera as criteria for not collecting the meat. The meat from roadkilled animals may pose a risk to the health of humans who consume it due to the foodborne diseases it may spread after the decomposition process. In addition, the practice of running over animals for consumption of their meat can cause potential impacts to the fauna and humans since it can reduce animal numbers and also cause serious accidents. Further investigations are needed to clarify whether this is widespread phenomenon occurring in other places of the Amazon and the Neotropics. [ABSTRACT FROM AUTHOR]

Fungal species have undergone and continue to undergo significant nomenclatural change, primarily due to the abandonment of dual species nomenclature in 2013 and the widespread application of molecular technologies in taxonomy allowing correction of past classification errors. These have effected numerous name changes concerning medically important species, but by far the group causing most concern are the Candida yeasts. Among common species, Candida krusei , Candida glabrata , Candida guilliermondii , Candida lusitaniae , and Candida rugosa have been changed to Pichia kudriavzevii , Nakaseomyces glabrata , Meyerozyma guilliermondii , Clavispora lusitaniae , and Diutina rugosa , respectively. There are currently no guidelines for microbiology laboratories on implementing changes, and there is ongoing concern that clinicians will dismiss or misinterpret laboratory reports using unfamiliar species names. Here, we have outlined the rationale for name changes across the major groups of clinically important fungi and have provided practical recommendations for managing change. [ABSTRACT FROM AUTHOR]

Loop-mediated isothermal amplification (LAMP) is a nucleic acid amplification technique that can be used to amplify target genes at a constant temperature, and it has several advantages, including convenience, specificity and sensitivity. However, due to the special interpretation methods of this technology for reaction results, all the previously reported LAMP detection methods have been restricted to identifying a single target, which limits the application of this technology. In this study, we modified conventional LAMP to include a quencher-fluorophore composite probe complementary to the F1c segment of the inner primer FIP; upon strand separation, a gain in the visible fluorescent signal was observed. The probes could be labeled with different fluorophores, showing different colors at the corresponding wavelengths. Therefore, this multiplex LAMP (mLAMP) assay can simultaneously detect 1–3 target sequences in a single LAMP reaction tube, and the results are more accurate and intuitive. In this study, we comprehensively demonstrated a single-reaction mLAMP assay for the robust detection of three cattle viruses without nonspecific amplification of other related pathogenic cattle viruses. The detection limit of this mLAMP assay was as low as 526–2477 copies/reaction for the recombinant plasmids. It is expected that this mLAMP assay can be widely used in clinical diagnosis. [ABSTRACT FROM AUTHOR]

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Studies comparing Paracoccidioides brasiliensis and Paracoccidioides lutzii have shown that these fungi have significant genomic differences that may have implications in the clinical manifestation, diagnosis, and treatment of paracoccidioidomycosis caused by them. Thus, molecular typing methods are required that can distinguish between various species of Paracoccidioides. The aim of this study was to explore the potential use as molecular markers of the transposable elements Trem A-H recently identified and characterized in the genus Paracoccidioides as a means of differentiating the species. We take advantage of the abundance and distribution of these transposons in the Paracoccidioides genomes to develop a simple and highly reproducible polymerase chain reaction (PCR)-based technique. Furthermore we compare the performance of this test with two other molecular markers already in use to identify these fungi. [ABSTRACT FROM AUTHOR]

We detected Histoplasma capsulatum in soil and penguin excreta in the Antarctic Peninsula by sequencing after performing species-specific PCR, confirming previous observations that this pathogen occurs more broadly than suspected. This finding highlights the need for surveillance of emerging agents of systemic mycoses and their transmission among regions, animals, and humans in Antarctica. [ABSTRACT FROM AUTHOR]

The order Onygenales is classified in the class Eurotiomycetes of the subphylum Pezizomycotina. Families in this order have classically been isolated from soil and dung, and two lineages contain causative agents of superficial, cutaneous and systemic infections in mammals. The ecology and habitat choices of the species are driven mainly by the keratin and cellulose degradation abilities. The present study aimed to investigate whether the ecological trends of the members of Onygenales can be interpreted in an evolutionary sense, linking phylogenetic parameters with habitat preferences, to achieve polyphasic definitions of the main taxonomic groups. Evolutionary processes were estimated by multiple gene genealogies and divergence time analysis. Previously described families, namely, Arthrodermataceae, Ajellomycetaceae, Ascosphaeraceae, Eremascaceae, Gymnoascaceae, Onygenaceae and Spiromastigoidaceae, were accepted in Onygenales, and two new families, Malbrancheaceae and Neogymnomycetaceae, were introduced. A number of species could not be assigned to any of the defined families. Our study provides a revised overview of the main lines of taxonomy of Onygenales, supported by multilocus analyses of ITS, LSU, TUB, TEF1, TEF3, RPB1, RPB2, and ribosomal protein 60S L10 (L1) (RP60S) sequences, combined with available data on ecology, physiology, morphology, and genomics. [ABSTRACT FROM AUTHOR]

Paracoccidioidomycosis (PCM) is a systemic mycosis caused by a group of cryptic species embedded in the Paracoccidioides brasiliensis complex and Paracoccidioides lutzii. Four species were recently inferred to belong to the P. brasiliensis complex, but the high genetic diversity found in both human and environmental samples have suggested that the number of lineages may be higher. This study aimed to assess the 43-kilodalton glycoprotein genotypes (PbGP43) in paraffin-embedded samples from PCM patients to infer the phylogenetic lineages of the P. brasiliensis complex responsible for causing the infection. Formalin-fixed, paraffin-embedded (FFPE) tissue samples from patients with histopathological diagnosis of PCM were analyzed. DNAs were extracted and amplified for a region of the second exon of the PbGP43 gene. Products were sequenced and aligned with other PbGP43 sequences available. A haplotype network and the phylogenetic relationships among sequences were inferred. Amino acid substitutions were investigated regarding the potential to modify physicochemical properties in the proteins. Six phylogenetic lineages were identified as belonging to the P. brasiliensis complex. Two lineages did not group with any of the four recognized species of the complex, and, interestingly, one of them comprised only FFPE samples. A coinfection involving two lineages was found. Five parsimony-informative sites were identified and three of them showed radical non-synonymous substitutions with the potential to promote changes in the protein. This study expands the knowledge regarding the genetic diversity existing in the P. brasiliensis complex and shows the potential of FFPE samples in species identification and in detecting coinfections. [ABSTRACT FROM AUTHOR]

Background: Paracoccidioidomycosis, caused by fungi of the Paracoccidioides genus, is one of the most important endemic mycoses in Brazil. The disease is not of mandatory reporting in the country; however, some Brazilian states, such as Paraná, have included it on their local lists of public health‐reportable diseases. Objective: Describe the epidemiology of the positive paracoccidioidomycosis cases in the state of Paraná based on analysis of reporting forms and mortality data. Subjects and methods: Data of positive cases of state residents 2007–2020 were obtained from public health databases and frequency, incidence, geographic distribution, mortality and trends were analysed. Mortality of the disease was also compared to other mycoses such as cryptococcosis, aspergillosis, histoplasmosis, candidiasis and sporotrichosis. Results: 670 patients were positive for the disease. The cumulative and average annual incidence was, respectively, 6.4 and 0.46 cases/100,000 inhabitants. The new cases of paracoccidioidomycosis were reported mainly by specialised health units, including tertiary centres, and 285 days was the mean from the beginning of the symptoms until the diagnosis. The western region showed the highest incidence and mortality by the disease over the other state mesoregions. During the period, a decreasing trend was observed in the confirmed cases and stability in the mortality rate with an average annual mortality of 1.17 per million/inhabitants in the state; however, paracoccidioidomycosis had the highest mortality when compared to other mycoses. Conclusions: Paracoccidioidomycosis is an important endemic mycosis in Paraná and this study provides an epidemiological baseline for future modifications of paracoccidioidomycosis surveillance. [ABSTRACT FROM AUTHOR]

Cryptococcosis is an opportunistic infection with high mortality if not diagnosed and treated in time. The objective of this study was to review the clinicopathological information of decendents with final autopsy diagnosis of disseminated cryptococcal infection. This study collected data from 4 decendents who presented to an academic hospital/laboratory between 1 January 2015 to 31 December 2018. Their clinical, radiological and pathological findings including treatment were reviewed. Two decendents presented with respiratory symptoms whilst the other 2 presented with meningeal symptoms. Three were confirmed HIV positive. One decendent was on ART, one had defaulted treatment and one was ART naïve. Two decendents were diagnosed with cryptococcal meningitis, one with bacterial pneumonia and one with pulmonary tuberculosis. Three decendents died in emergency unit and one in the ward whilst on antifungal therapy. The autopsy findings confirmed disseminated cryptococcal infection in all cases. A high index of suspicion should be maintained in the right clinical context. Multi-organ involvement should be suspected in all patients and be actively sought out. [ABSTRACT FROM AUTHOR]

Background: Histoplasmosis is a chronic granulomatous disease caused by the thermally dimorphic fungus Histoplasma capsulatum. The 2 variants Histoplasma capsulatum var. capsulatum (Hcc) and Histoplasma capsulatum var. duboisii (Hcd) causes infection in humans and commonly termed classical or American histoplasmosis and African histoplasmosis, respectively. Histoplasma capsulatum var. farciminosum (Hcf) affects equines. In recent times, there have been heightened sensitization on fungal infections such as histoplasmosis in Africa, aimed at improving awareness among relevant stakeholders, particularly healthcare workers. This effort is expected to be paralleled with increased detection of both classical and African histoplasmosis, which has remained underdiagnosed over the years. In this narrative review, we describe the current perspectives of histoplasmosis in Africa, identify knowledge gaps, and suggest research priorities. Methods: A PubMed, Google Scholar, and Africa Journal Online (AJOL) literature search was conducted for studies on histoplasmosis in Africa between 2000 and 2020. Histoplasmosis essays in medical mycology textbooks were also consulted. This narrative review was prepared from the data gathered. Findings: In the past 2 decades, histoplasmosis in general has seen a relative increase in case detection in some Africa countries, probably attributable to the gradually increasing medical mycology advocacy efforts in Africa. Histoplasmosis cases are dominated by African histoplasmosis mostly in Western and Central Africa, while classical histoplasmosis is more common in Southern and Northern Africa. Although both classical and African histoplasmosis are common in Africa, the latter is more restricted to Africa, and cases outside the continent usually have a travel history to the continent. Despite the clinical and laboratory difference between African histoplasmosis and classical histoplasmosis, it is not straightforward to distinguish them. The typical manifestation of African histoplasmosis is the appearance of lesions affecting the skin, bones, and lymph nodes and unusually linked to human immunodeficiency virus (HIV)/AIDS. By contrast, classical histoplasmosis mostly affects the lungs and is often associated with immunosuppression, mainly HIV/AIDS. The present perspectives of histoplasmosis in Africa highlight unclear details on the true burden, strain diversity, infection route and genetic basis of African histoplasmosis, availability of specie-specific diagnostic tools, and compliance with recommended antifungal therapy. These knowledge gaps represent research questions that require scientific exploration. Conclusions: Despite a subtle increase in identifying histoplasmosis cases in Africa, it remains underdiagnosed and neglected in some parts of the continent. Increasing awareness and training among healthcare workers, bridging diagnostic and therapeutic gaps, and encouraging more research in Africa are crucial to improve the current perspectives of histoplasmosis in Africa. [ABSTRACT FROM AUTHOR]

Two glomoid spore-producing arbuscular mycorrhizal fungi were grown in single-species cultures that were established from soil-borne spores collected from high altitude (2800 m a.s.l.) of Tibet Plateau, China. Phylogenetic analyses were performed with sequences of nuclear rDNA (spanning the partial small subunit, whole internal transcribed spacer, and partial large subunit segment; 18S-ITS-28S) and the largest subunit of RNA polymerase II (RPB1) gene. Morphological and phylogenetic analyses indicated that the two fungi are undescribed species of the genera Glomus and Dominikia. The first fungus, described here as G. chinense sp. nov., forms spores singly or in loose clusters. The spores are orange-yellow to dark brown, globose, and (47–)64(–93) μm diam. Dominikia gansuensis sp. nov. produces glomerocarps with pale yellow to yellow-brown, globose, (20–)47(–86) μm diam spores. The spore wall of both species consists of three layers. Both species differ clearly in morphology and phylogeny from their closest phylogenetic relatives, which are G. atlanticum and G. ibericum, and D. glomerocarpica, respectively. [ABSTRACT FROM AUTHOR]

Monitoring wildlife roadkills is a valuable method to identify critical areas where animals are more susceptible to collision with vehicles, likewise, this type of work can let us know which species are more vulnerable to this human impact. Besides these relevant utilities used for mitigation purposes, this effort can provide very important information about the biology, ecology and biogeography of species. In this paper, we report new geographic records found while working on a road ecology study. These data increase the distribution of six snakes' species (Anilius scytale, Drymarchon corais, Erythrolamprus breviceps, Micrurus lemniscatus, Oxyrhopus vanidicus and Trilepida anthracina), from which, four show scarce and almost inexistent historical records (Anilius scytale, Drymarchon corais, Erythrolamprus breviceps, and Trilepida anthracina). We encourage researchers, especially road ecologists, to notice and report these observations, which can be highly valuable for expanding the knowledge of species distributions, a key factor forconducting integral studies of fauna. [ABSTRACT FROM AUTHOR]

Purpose: This article shows reports of the clinical–epidemiological characteristics and serological screening in patients assisted by a reference center for PCM care, University Hospital Cassiano Antonio Moraes, Federal University of Espirito Santo, Brazil. Methods: The patient's sera with PCM were analyzed by DID test at the beginning and the end treatment. Clinical and demographic data were also collected to characterize the sample. Results: One hundred patients with a suspected diagnosis of PCM were evaluated. Serology by DID test was used as a screen in all patients. The test was positive for 79 patients (72 for Paracoccidioides brasiliensis and 7 for Paracoccidioides lutzii). Serology was negative in 21 sera, although all of them were diagnosed PCM by histopathologic or direct exam. Serological follow-up was performed during the treatment of all patients. After treatment, 58(58%) had negative serology and 33(33%) low levels of antibodies (≤ 1:16). Conclusion: Our results indicate the importance of the DID test for the screening and monitoring of PCM and that the incidence of P. lutzii might be greater than expected in areas where it is not the predominant PCM species. Therefore, this article may contribute to improving the knowledge and clinical management about this disease. [ABSTRACT FROM AUTHOR]

Introduction: Paracoccidioidomycosis (PCM) is caused by several species of the Paracoccidioides genus which can be differentiated by interspecific genetic variations, morphology and geographic distribution. Intraspecific variability correlation with clinical and epidemiological aspects of these species still remains unclear. This study aimed to sequence the loci GP43, exon 2 and ARF of 23 clinical isolates of Paracoccidioides spp. from patients in the Southeast Region of Brazil. Methodology and main findings: GenBank was used to compare the present (23) with previous described sequences (151) that included ARF and GP43. It was identified a high polymorphism rate among the 23 isolates in comparison to the other 151. Among the isolates, 22 (95,66%) were S1/P. brasiliensis and 1 (4,34%) was identified as PS2/P. americana. A total of 45 haplotypes were found as follows: 19 from S1/P. brasiliensis (13 from the present study), 15 from P. lutzii, 6 from PS2/P. americana (1 from the present study), 3 from PS3/P. restrepiensis and 2 from PS4/P. venezuelensis. Moreover, exclusive haplotypes according to clinical origin and geographical area were found. S1/P. brasiliensis (HD = 0,655 and K = 4,613) and P. lutzii (HD = 0,649 and K = 2,906) presented the highest rate of polymorphism among all species, from which 12 isolates of the present study were clustered within S1b/P. brasiliensis. The GP43 locus showed a higher variability and was found to be the main reason for the species differentiation. Conclusions: The results herein decribed show a high intraspecific genetic variability among S1/P. brasiliensis isolates and confirm the predominance of this species in the Southeast region of Brazil. The finding of exclusive haplotypes according to clinical origin and geographical area would suggest correlation between the molecular profile with the clinical form and geographic origin of patients with PCM. Author summary: Paracoccidioidomycosis (PCM) is one of the most important systemic mycosis of Latin America. This disease can be caused by Paracoccidioides lutzii and four different phylogenetic species: S1/Paracoccidioides brasiliensis sensu stricto that harboring S1a and S1b, PS2/Paracoccidioides americana, PS3/Paracoccidioides restrepiensis and PS4/Paracoccidioides venezuelensis. Some of these species show differences in their main geographic region of predominance such as PS2/P. americana that can be found in Venezuela and Southern Brazil; PS3/P. restrepiensis and PS4/P. venezuelensis which are distributed in Colombia and Venezuela. However, and due to their wide geographical distribution, the species S1/P. brasiliensis and P. lutzii overlapping ecological niches and can be found in different regions of Brazil and other Latin American countries. Regarding eco-epidemiological aspects, the habitat is believed to be the soil due to the predominance of the disease among rural workers who become infected by inhaling infectious propagules during their farm activities. According to other authors, these species could have relation with the different PCM clinical presentation. This study aimed to describe the molecular epidemiology associated with clinical and epidemiological data of Paracoccidiodes spp. in the Minas Gerais State, located in the Southeast region, Brazil. Among the 23 isolates herein evaluated, 22 were S1/P. brasiliensis and 1 was identified as PS2/P. americana. A total of 45 haplotypes were found when these isolates were compared with other 151 deposited in the Genbank. The preliminar finding of exclusive haplotypes according to clinical origin and geographical area would suggest correlation between the molecular profile with the clinical form and geographic origin of patients with PCM. The GP43 locus showed a higher variability and was found to be the main promotor of species differentiation. The results herein described pointed out a high intraspecific genetic variability among S1/P. brasiliensis isolates and confirm the predominance of this species in the Southeast region of Brazil. [ABSTRACT FROM AUTHOR]

As there are more than 6 million human deaths due to mycoses each year, there is an urgent need to develop fungal vaccines. Moreover, given the similarities among pathogenic fungi, it may be possible to create a multi-fungi vaccine. In this study, we combined immunoproteomic and immunopeptidomic methods, for which we have adapted a technique based on co-immunoprecipitation (Co-IP) that made it possible to map Histoplasma capsulatum epitopes for the first time in a natural context using murine dendritic cells (DCs) and macrophages (Mφ). Although polysaccharide epitopes exist, this research focused on mapping protein epitopes as these are more immunogenic. We used different algorithms to screen proteins and peptides identified by two-dimensional electrophoresis (2-D) and Co-IP. Seventeen proteins were revealed by 2-D gels, and 45 and 24 peptides from distinct proteins were presented by DCs and Mφ, respectively. We then determined which epitopes were restricted to MHC-I and II from humans and mice and showed high promiscuity, but lacked identity with human proteins. The 4 most promising peptides were synthesized, and the peptides with and without incorporation into glucan particles induced CD4+ and CD8+ T cell proliferation and produced a Th1 and Th17 response marked by the secretion of high levels of IFN-γ, IL-17 and IL-2. These epitopes were from heat shock protein 60, enolase, and the ATP-dependent molecular chaperone HSC82, and they each have a high degree of identity with proteins expressed by other medically important pathogenic fungi. Thus, the epitopes described in this study have the potential for use in the development of vaccines that could result in cross-protection among fungal species. [ABSTRACT FROM AUTHOR]

Iridoids are widely found from species of Bignoniaceae family and exhibit several biological activities, such as anti-inflammatory, antimicrobial, antioxidant, and antitumor. Specioside is an iridoid found from Tabebuia species, mainly in Tabebuia aurea. Thus, here fungus-mediated biotransformation of the iridoid specioside was investigated by seven fungi. The fungus-mediated biotransformation reactions resulted in a total of nineteen different analogs by fungus Aspergillus niger, Aspergillus flavus, Aspergillus japonicus, Aspergillus terreus, Aspergillus niveus, Penicillium crustosum, and Thermoascus aurantiacus. Non-glycosylated specioside was the main metabolite observed. The other analogs were yielded from ester hydrolysis, hydroxylation, methylation, and hydrogenation reactions. The non-glycosylated specioside and coumaric acid were yielded by all fungi-mediated biotransformation. Thus, fungus applied in this study showed the ability to perform hydroxylation and glycosidic, as well as ester hydrolysis reactions from glycosylated iridoid. Key points: • The biotransformation of specioside by seven fungi yielded nineteen analogs. • The non-glycosylated specioside was the main analog obtained. • Ester hydrolysis, hydroxylation, methylation, and hydrogenation reactions were observe [ABSTRACT FROM AUTHOR]

Histoplasmosis is one of the most frequent causes of fungal respiratory infection in endemic regions, has a broad spectrum of clinical manifestations and can present in several forms. The extent of disease is determined by the number of conidia inhaled, the immune response of the host and the integrity of the respiratory tract. From an initial and most benign form, acute pulmonary histoplasmosis (an influenza-like illness that is typically asymptomatic or mild in persons without prior immune compromise), histoplasmosis can become a lifethreatening progressive disseminated infection (PDH) that affects mainly immunocompromised patients, with high morbidity and mortality. Chronic pulmonary histoplasmosis is an uncommon manifestation of Histoplasma infection, with features similar to pulmonary tuberculosis, and if it remains undiagnosed or untreated it also can cause significant morbidity. Some rare but serious complications may also occur that are produced by an excessive immune response, such as mediastinal fibrosis, histoplasmoma and broncholithiasis. Histoplasmosis is highly endemic in regions of North, Central and South America as well as being reported in parts of Asia and Africa. The risk of histoplasmosis is greatest in patients with HIV infection, especially those with CD4+ counts of <200 cells/μL. We review clinical manifestations, radiological findings and treatment options according to the clinical form (induction therapy and maintenance therapy), as well as different diagnosis tools and new laboratory tests that have been recently developed and validated and are becoming widely available. These should have an impact in reducing time for diagnosis and starting therapy and in reducing morbidity and mortality, especially in patients with HIV infection, where histoplasmosis is currently estimated to be responsible for 5-15% of AIDS-related deaths. [ABSTRACT FROM AUTHOR]