Search

Objective: This study evaluated the mortality risk factors in Iranian patients with diabetes mellitus (DM) and COVID-19-associated mucormycosis (CAM). Methods: This retrospective study was conducted on confirmed CAM cases with DM. Only patients with a confirmed history of COVID-19 within the last 3 months were included. The patients were divided into the survived and deceased groups, and each group's characteristics were studied and compared. Patients were also studied according to their DM status (known or unknown case). Results: A total of 106 patients were included. The mortality rate was 25.5%. The most common underlying disease (hypertension, 41.5%) was significantly higher in the deceased group. Sixty-five patients (62.5%) were known cases of DM. The mean duration of DM was 12.46 years. There was a significant relationship between the DM history and mortality rate (84.6% vs. 15.4%, p = 0.007). The history of ICU admission was 8 times higher in unknown DM patients (p = 0.011, OR = 8.000, CI = 1.60–39.95). The mean HbA1C was significantly different in known DM cases (9.36 ± 2.03 vs. 8.02 ± 2.40, p = 0.004). The mean first day FBS, mean first BS in emergency room, and mean FBS on the first hospitalization week were 171, 202, and 167.2 mg/dL, respectively. Although mortality was significantly related to hyperglycemic state of fasting and non-fasting BS levels (p < 0.05), it was not related to HbA1C. Conclusion: Patients with diabetes and COVID-19 had uncontrolled fasting and non-fasting glucose levels during mucormycosis episode. Hypertension, history of DM, and the lack of glucose control during recent hospitalization can be associated with a poor outcome. [ABSTRACT FROM AUTHOR]

In recent years, strawberry cultivation in Spain has been increasingly affected by new and re-emerging fungal diseases. The most significant emerging diseases in Spain include those caused by Neopestalotiopsis spp. Maharachch., K.D.Hyde & Crous and Fusarium oxysporum f. sp. fragariae Winks & Y.N. Williams. These pathogens are difficult to control due to their pathogenic variability (presence of pathotypes and/or races), the lack of knowledge about the susceptibility of the different cultivars, the limited availability of effective fumigants, and the absence of sufficient information about their sources of inoculum. Both pathogens can cause root and crown rot, leading to plant collapse and significant losses for strawberry producers. Several factors have contributed to the rise of these diseases in Spain: (i) the gradual ban on key soil fumigants has left the crop vulnerable; (ii) there has been a notable diversification in the origin of mother plants used in cultivation, with plants now sourced from various countries, increasing the risk of long-distance pathogen spread; (iii) the introduction of numerous new strawberry varieties, which exposes more genotypes to pathogenic infections; and (iv) changes in planting times, leading to younger and more vulnerable plants being exposed to heat stress, as well as an increase in disease susceptibility. Neopestalotiopsis spp. and Fusarium oxysporum f. sp. fragariae have also become major threats to strawberry crops worldwide, spreading through nursery plants and the movement of plant material. The latest research findings in Spain on both pathogens are highlighted in this manuscript. [ABSTRACT FROM AUTHOR]

Passion fruit (Passiflora edulis Sims) is a Passifloraceae plant with high economic value. Crown rot caused by Rhizoctonia solani is a major fungal disease, which can seriously reduce the yield and quality of passion fruit. Receptor-like proteins (RLPs), which act as pathogen recognition receptors, are widely involved in plant immune responses and developmental processes. However, the role of RLP family members of passion fruit in resistance to crown rot remains unclear. In this study, evolutionary dynamics analysis and comprehensive genomic characterization of the RLP genes family were performed on passion fruit. A total of 141 PeRLPs in the genome of the 'Zixiang' cultivar and 79 PesRLPs in the genome of the 'Tainong' cultivar were identified, respectively. Evolutionary analysis showed that proximal and dispersed duplication events were the primary drivers of RLP family expansion. RNA-seq data and RT-qPCR analysis showed that PeRLPs were constitutively expressed in different tissues and induced by low temperature, JA, MeJA, and SA treatments. The PeRLP8 gene was identified as the hub gene by RNA-seq analysis of passion fruit seedlings infected by Rhizoctonia solani. The expression levels of PeRLP8 of the resistant variety Passiflora maliformis (LG) were significantly higher than those of the sensitive variety Passiflora edulis f. flavicarpa (HG). Transient overexpression of PeRLP8 tobacco and passion fruit leaves enhanced the resistance to Rhizoctonia solani, resulting in reduced lesion areas by 52.06% and 54.17%, respectively. In addition, it can increase reactive oxygen species levels and upregulated expression of genes related to active oxygen biosynthesis and JA metabolism in passion fruit leaves. Our research provides new insights into the molecular mechanism and breeding strategy of passion fruit resistance to crown rot. [ABSTRACT FROM AUTHOR]

Pulmonary mucormycosis is a rare and aggressive invasive fungal infection that predominantly affects immunocompromised individuals, such as those with diabetes mellitus or those undergoing immunosuppressive therapy. This case describes a severe instance of pulmonary mucormycosis resulting in progressive tracheal wall destruction in a young, previously healthy male. A 20-year-old male with a denied history of diabetes mellitus was admitted to a local hospital with abdominal pain for 9 days and diagnosed with acute pancreatitis and diabetic ketoacidosis (DKA). During his stay at the local hospital the patient developed respiratory distress and was transferred to our hospital. Although initially given non-invasive respiratory support and broad-spectrum antibiotics, the patient's condition deteriorated and invasive mechanical ventilation and VV-ECMO were given. Bronchoalveolar lavage fluid (BALF) next-generation sequencing (mNGS) identified Rhizopus species, confirming pulmonary mucormycosis. Aggressive antifungal therapy with amphotericin B was administered, followed by the addition of isavuconazole, but the patient's lesions continued to expand, ultimately leading to fatal tracheal and bronchial wall disruption and subsequent haemorrhage. This case emphasizes the rapid progression and extensive tissue destruction characteristics of pulmonary mucormycosis. Early diagnosis and treatment, especially simultaneous antifungal therapy and appropriate surgical intervention, are crucial for improving the prognosis of such severe cases. [ABSTRACT FROM AUTHOR]

Fungal infections have become a growing public health concern, aggravated by the emergence of new pathogenic species and increasing resistance to antifungal drugs. The most common candidiasis is caused by Candida albicans; however, Candida dubliniensis has become an emerging opportunistic pathogen, and although less prevalent, it can cause superficial and systemic infections, especially in immunocompromised individuals. This yeast can colonize the oral cavity, skin, and other tissues, and has been associated with oral infections in patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), making it difficult to treat. The special interest in the study of this species lies in its ability to evade commonly used antifungal drugs, such as fluconazole, under different concentrations. In addition, it is difficult to identify because it can be confused with the species C. albicans, which could interfere with adequate treatment. Although the study of virulence factors in C. dubliniensis is limited, proteomic comparisons with C. albicans indicate that these virulence factors could be similar between the two species. However, differences could exist considering the evolutionary processes and lifestyle of each species. In this study, a detailed review of the current literature on C. dubliniensis was conducted, considering aspects such as biology, possible virulence factors, immune response, pathogen–host interaction, diagnosis, and treatment. [ABSTRACT FROM AUTHOR]

Scedosporium apiospermum (S. apiospermum) can cause fungal infections in near-drowning victims, and an increasing number of cases have been reported. However, cases of bone and joint infections caused by S. apiospermum are rare. In this case, a 35-year-old otherwise healthy Chinese female presented with aspiration pneumonia and knee arthritis after accidentally falling into sewage and near-drowning and underwent macrogenomic second-generation sequencing of arthrocentesis fluid, which showed S. apiospermum. However, new lesions involving the hip joint and spine continued to develop under voriconazole monotherapy. The patient was treated with voriconazole combined with amphotericin B cholesterol sulfate lipid complex for 30 consecutive days. The patient's symptoms improved significantly. This case highlights the robust invasiveness of S. apiospermum and the extensive spread of infection, underscoring the importance of prompt diagnosis and treatment. A combined therapeutic approach may offer a safe and efficacious option for managing S. apiospermum infection. [ABSTRACT FROM AUTHOR]

Ketoconazole is a broad-spectrum Imidazole derivative antifungal that is effective for both superficial and systemic fungal infections that cannot be completely absorbed when administered orally because it has low solubility. This can be overcome by forming a ketoconazole niosome delivery system. Niosomes are vesicular systems formed using non-ionic surfactants that could increase the solubility and bioavailability of drugs. The purpose of this study was to form a ketoconazole niosome system to increase the bioavailability and therapeutic effectiveness of ketoconazole. Niosomes were made into nine formulas using 100 mg surfactant with variations in the combination of non-ionic surfactant concentrations Span 60 (70.80-98.29%):Sucrose Ester Palmitate (SEP) (1.71-29.20%), which produced Hydrophilic Liphophilic Balance (HLB) values between 4-8. The evaluations on niosomes were organoleptic tests, particle size tests, polydispersity indexes, zeta potentials, structural analysis using Forrier Transform Infra Red (FTIR), morphological analysis using Transmission Electron Microscope (TEM), entrapment efficiency tests and drug release tests. The results showed that the niosome system with an HLB value of 7.5 produced a vesicle size 336,13±3,14 nm, polydispersity index 0,000, zeta potensial - 52,16±1,54 mV, spherical form of vesicle and no found chemistry interaction between the components (result of TEM and FTIR), an entrapment efficiency value of 87.86±0.18% and a drug release test value for 24 hours of 97.23±2.16%. This showed that the ketoconazole niosome system made using a combination of span 60 surfactants and SEP with an HLB value of 7.5 was able to produce an excellent niosome system. [ABSTRACT FROM AUTHOR]

Pathogenic fungi represent a diverse group of eukaryotic microorganisms that significantly impact human health and agriculture. In recent years, the role of epigenetic modifications, particularly histone modifications, in fungal pathobiology has emerged as a prominent area of interest. Among these modifications, methylation of histone H3 at lysine-4 (H3K4) has garnered considerable attention for its implications in regulating gene expression associated with diverse cellular processes. A body of literature has uncovered the pivotal roles of H3K4 methylation in multiple biological processes crucial for pathogenic adaptation in a wide range of fungal pathogens of humans and food crops. This review delves into the recent advancements in understanding the impact of H3K4 methylation/demethylation on fungal pathogenesis. We explore the roles of H3K4 methylation in various cellular processes, including fungal morphogenesis and development, genome stability and DNA repair, metabolic adaptation, cell wall maintenance, biofilm formation, antifungal drug resistance, and virulence. We also discuss the conservation of H3K4 methylation regulators and their potential as therapeutic targets to prevent fungal diseases. Collectively, this review underscores the intricate links between H3K4 methylation, fungal pathogenesis, and potential avenues for novel antifungal strategies. [ABSTRACT FROM AUTHOR]

The intestinal mycobiome is closely related to human health. There have been several reports investigating the association between the gut fungi and disease, but there is still a lack of overall assessment of the human gut mycobiome. Here, we performed a meta-analysis based on 2372 ITS (Internal Transcribed Spacer) data collected publicly online. We found that the mycobiome diversity of human gut fungi varies significantly across diseases by using EasyAmplicon, and these fungi are mainly composed of three genera, Saccharomyces, Candida, and Aspergillus. In addition, we performed the construction of disease prediction models based on ITS data by using the random forest model and verified the generalization ability of the models. We hope that our results will provide strong support for subsequent studies of the intestinal mycobiome. [ABSTRACT FROM AUTHOR]

Few studies have focused on the infectious complications in kidney transplant recipients in tropical regions, particularly in the Caribbean. The primary objective of this study was to determine the incidence of bacterial, fungal, and parasitic infections in kidney transplant recipients in the French Caribbean and French Guiana. We included all patients who received a kidney transplant at the University Hospital of Guadeloupe between January 2014 and October 2016, with post-transplant follow-up in the French Caribbean. A total of 91 patients were included, of whom 57 developed an infectious event during follow-up. When infections were documented (94/111), bacterial infections were the most frequent (79/94), followed by fungal (11/94) and parasitic infections (4/94). Four cases of nocardiosis were identified (4/79). Phaeohyphomycosis was the most common fungal infection (7/11). In a multivariate analysis, the female gender and diabetes mellitus at the time of transplant were significantly associated with a higher risk of infection. This study is the first to describe the epidemiology of infections in kidney transplant recipients in the Caribbean and to analyze the potential risk factors. We reported a similar profile of bacterial infections to that which were observed in the European and American studies. However, we found a higher incidence of tropical infections, such as nocardiosis and phaeohyphomycosis, which highlights the need for heightened awareness among healthcare teams to ensure earlier and more appropriate treatment. Further studies focusing on these rare tropical infections are necessary to better understand their risk factors [ABSTRACT FROM AUTHOR]

Over the past three decades, there has been an increase in the severity of fungal infections, affecting several individuals and claiming the lives of more than 1.6 million people every year. Species of Candida are one of the causatives of invasive fungal infections, and the extensive use of antifungals for their treatment has led to the emergence of drug resistance in these species, highlighting the need for the exploration of effective and cost-effective therapeutics. Drug repurposing is an important solution for alternative therapeutics. There are many studies where antifungal indications of any existing drug have been analyzed with an aim to establish new antimycotic therapeutics in a short time and with a lower budget. In this review, efforts are made to compile the literature on repurposed drugs against clinical isolates of Candida and fungal pathogens to better illustrate drug repurposing's role in the treatment of candidiasis. [ABSTRACT FROM AUTHOR]

Root and butt rot, caused by Heterobasidion species, poses a significant threat to coniferous forests in the Northern Hemisphere. Innovative and effective strategies are crucial to enhance the control of this disease. This study aimed at identifying a Streptomyces strain, FY4, and evaluating its biocontrol potential against H. annosum and H. parviporum. Strain FY4 was identified as Streptomyces blastmyceticus based on morphological, physiological, and biochemical characteristics, supported by a multigene phylogenetic analysis using the 16S rRNA, atpD, rpoB, and trpB genes. In vitro dual-culture experiments showed that S. blastmyceticus exhibited antagonistic activity against both H. annosum and H. parviporum, with an inhibition zone diameter exceeding 15 mm. Moreover, the fermentation broth of S. blastmyceticus FY4 displayed significant inhibitory effects on the mycelial growth and spore germination of both Heterobasidion species. At a 10% concentration, the fermentation broth inhibited the mycelial growth by over 90% and reduced the spore germination rate by more than 60%. Additionally, the fermentation broth exhibited significant inhibitory effects on the mycelial growth of four common pathogenic fungi—Phytophthora cinnamomi, P. sojae, Rhizoctonia solani, and Verticillium dahlia, with an inhibition rate over 50%. These findings suggest that S. blastmyceticus FY4 produces antifungal substances capable of effectively suppressing infection of Heterobasidion species in conifers. Consequently, strain FY4 holds great promise as a biological control agent for managing root and butt rot caused by these pathogens, as well as potential for controlling other fungal diseases. [ABSTRACT FROM AUTHOR]

Featured Application: The work presents information on the potential for the synthesis of hydrogels comprising gold nanoparticles coated with itraconazole, together with an evaluation of their potential utility. Gold nanoparticles have been identified as a promising avenue for the development of drug carriers, particularly in the context of antimicrobial drug delivery, where limited solubility represents a significant challenge. The ability of gold nanoparticles to penetrate biofilms and disrupt fungal cell membranes makes them an effective tool to support antifungal therapy, especially against resistant strains. Gold nanoparticles also demonstrate synergistic effects with chemotherapeutics and can influence the release profile of the active substances. This study aimed to develop a topical hydrogel drug formulation containing itraconazole (ITZ), with the addition of gold nanoparticles, to enhance its therapeutic properties. Due to ITZ's poor water solubility, three types of the gold nanoparticles (AuNPs) of different sizes were synthesized and subsequently coated with itraconazole. The resulting formulations were incorporated into carbopol gels and their ability to diffuse through semipermeable membranes was assessed. The findings demonstrated that the combination of gold nanoparticles and itraconazole elevated the diffusion coefficient to twice the level observed in gels without nanoparticles. Furthermore, the combined effect of gold nanoparticles and itraconazole against a reference Candida albicans strain was investigated. The combination of gold nanoparticles and itraconazole demonstrated a growth-inhibitory effect on this strain, indicating that this formulation could potentially be employed in the treatment of fungal infections. The study confirms that hydrogels with itraconazole and gold nanoparticles can be obtained, offering enhanced drug diffusion. [ABSTRACT FROM AUTHOR]

Copyright of Türk Radyoloji Seminerleri is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Tomatoes (Solanum lycopersicum L.) are a widely grown and globally traded vegetable, essential for both local consumption and international trade. However, approximately 30% of harvested tomato yields are lost due to fungal decay during postharvest handling. Timely disease identification is crucial to prevent such losses, but certain tomato varieties exhibit higher susceptibility to fungal infections than others. Additionally, there are variations in susceptibility among individual sepals, with unknown underlying causes. Traditional methods for assessing fungal presence in plants have limitations, such as sample destruction and a focus on symptom detection rather than evaluating susceptibility to fungal infection. Hence, there is a demand need for an accurate, non-destructive method capable of predicting susceptibility to fungal infection. The use of hyperspectral imaging (HSI) with chemometrics presents a pioneering approach to address this need. In this study, three tomato cultivars ('Brioso,' 'Cappricia,' and 'Provine') were studied. Hyperspectral images were captured on day-1 of harvest, followed by controlled fungal growth conditions. Ground truth assessments were conducted by three experts on day-3 and day-4, averaging severity scores assigned per sepal. The methodology involved extracting spectra from HSI images and calibrating and validating models using partial least squares discriminant analysis (PLSDA), aiming to optimize model parameters for accurate predictions. The models were categorized into those developed using data from a single variety (intravariety) and those utilizing data from multiple varieties combined (global models). The best-performing intravariety model was established using the Cappricia variety, achieving a balanced accuracy of 0.84. Conversely, a global model combining Cappricia and Provine varieties achieved a balanced accuracy of 0.70. Overall, the results suggest that distinguishing between more and less susceptible sepals is feasible under controlled conditions. [ABSTRACT FROM AUTHOR]

Copyright of Namık Kemal Tıp Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Mucormycosis hand infection in poorly controlled diabetic presented as rapidly progressive swelling, redness, pain, and necrosis unresponsive to antibiotics. Prompt diagnosis and aggressive surgery, antifungals, and diabetes management were critical, highlighting the need for early recognition and treatment of mucormycosis in diabetics. [ABSTRACT FROM AUTHOR]

Objective: The hellbender Cryptobranchus alleganiensis is a fully aquatic, long‐lived, and state endangered salamander endemic to the eastern and central United States. Chytridiomycosis is a fungal skin disease of salamanders that can be caused by either Batrachochytrium dendrobatidis (Bd) or by recently described B. salamandrivorans. B. salamandrivorans is responsible for massive mortality of salamanders in Europe but, to date, has not been reported in the United States, in contrast to Bd. Common signs of Bd infection in salamanders are excessive skin shedding; cutaneous discoloration; mainly in ventral parts of the abdomen and thighs; and eventually death as a result of osmotic imbalance. Methods: Eastern hellbenders C. a. alleganiensis in the Aquaculture Research Laboratory at Purdue University experienced 33% mortality. Three of the deceased animals were autopsied, and samples for histopathology, microbiology, and Taqman quantitative polymerase chain reaction were taken. Result: Autopsy revealed an abundant, thick, yellow to green mucoid material on the surface of the skin, mainly on the tail and flanks. Histopathology of the skin samples revealed infection with chytrid fungus consistent with chytridiomycosis. Taqman quantitative polymerase chain reaction confirmed presence of Bd, and bacterial culture confirmed co‐infection with Aeromonas hydrophila. Infected hellbenders were treated with ciprofloxacin, itraconazole, and ceftazidime. Conclusion: The chytridiomycosis outbreak was most likely caused by sudden environmental stress due to filtration failure and secondary bacterial infection. The surviving animals have not shown any clinical signs of chytridiomycosis for more than 1 year after the treatment and were released the wild river system. Impact statementHellbenders are large salamanders, unique to the United States, that live in clean, fast‐flowing streams and rivers. This species has declined throughout, mostly due to pollution causing environmental stress. This article describes an outbreak of fungal disease in laboratory‐reared hellbenders, which was most likely incited by stress due to the failure of the filtration system. [ABSTRACT FROM AUTHOR]

Diaphania indica (Lepidoptera: Crambidae) is one of the most important pests infesting many cucurbitaceous vegetables. During the rearing of insect eggs, we observed a fungal infection in these insect eggs which causes the death of pests. Therefore, this work aimed to isolate and identify this fungus by amplifying the internal transcribed spacer (ITS) region of the rDNA, as well as evaluating the efficiency of this fungus in control. Aspergillus flavus, 'PP125556', showcased robust pathogenicity against a range of D. indica pests. The results showed that colonies of 'PP125556' cultivated on potato dextrose agar (PDA) exhibited distinctive morphological characteristics, transitioning from pristine white to verdant green. Bioassays demonstrated concentration-dependent mortality rates of D. indica larvae and adults when exposed to varying concentrations of 'PP125556' conidia, with the highest concentration (1 × 109 conidia/mL) inducing significant death, with the highest mortality (53.06% for eggs, 70.57% for larvae, and 86.65% for adults). Furthermore, examination under a stereomicroscope revealed conspicuous external symptoms in infected larvae, including reduced mobility, darkened body pigmentation, and the emergence of white hyphae, indicative of mortality. Additionally, infected eggs exhibited inhibited hatching and the emergence of green hyphae, while infected adults displayed mortality and white hyphae colonization, underscoring the potent biocontrol efficacy of A. flavus 'PP125556' against D. indica across diverse developmental stages. [ABSTRACT FROM AUTHOR]

Clusterbean, Cyamopsis tetragonoloba (L.) Taub., also known as Guar or Guwar, is a vital legume crop grown in arid and semi-arid regions in India. However, it faces challenges from phytopathogenic fungal and bacterial diseases, notably stem rot caused by Sclerotium rolfsii, leading to significant yield losses. The fungus has a broad host range, surviving as sclerotia on plant debris and thriving under warm and moist conditions. Among the forty germplasms/varieties, two germplasms/varieties were highly resistant against the stem rot disease of cluster beans, whereas 12 germplasms/varieties showed a resistant reaction. Fifteen germplasms/varieties were moderately resistant, eight showed moderately susceptible reactions, two were susceptible, and only one showed a highly susceptible response against the disease. [ABSTRACT FROM AUTHOR]

Copyright of Anaesthesiologie & Intensivmedizin is the property of DGAI e.V. - Deutsche Gesellschaft fur Anasthesiologie und Intensivmedizin e.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pesticide-free agricultural strategies need new tools for disease prevention. Better than early detection of disease, detection of conditions favorable to their appearance can be a progress. In the case of fungal diseases, the presence of water on the plant surface is necessary. In order to detect remotely this presence early and at the scale of a crop field, we propose a low-cost solution based on laser reflection. Here, experimental results in a controlled environment are presented on both hydrophobic and hydrophilic leaves (rapeseed Brassica Napus and grapevine Vitis Vinifera, respectively). We first assess the water detection on a leaf surface by recreating the dew formation process. We next evaluate the influence of the scanning measurement and leaf inclination on the detection to get closer to in-field conditions. Results show that this method is very sensitive on both types of leaves. Water detection is possible from a low surface coverage with a high temporal precision at 1 m. In the hydrophobic case, water on a leaf surface leads to an increase of the detected signal up to three times compared to a dry leaf. The corresponding minimum surface coverage detectable at 1 m is evaluated at 1.6% thanks to 2D ray-tracing numerical simulations. In the hydrophilic case, on the contrary, water on a leaf surface leads to a decrease of the detected signal by almost half. For both types, the dew detection delay is contained under 5 min and can be improved. Finally, the presented results pave the way to a field application. [ABSTRACT FROM AUTHOR]

PURPOSE OF REVIEW: The endemic fungi are a significant cause of morbidity and mortality in effected patients. The range of endemicity for these are expanding with infections observed outside of traditional locations. Enhanced diagnostic and treatment practices may significantly alter patient outcomes. RECENT FINDINGS: Recently completed clinical trials have focused on an assessment of improving efficacy while minimizing patient toxicity. Practice changing trials have been completed in histoplasmosis showing the utility of a single up-front liposomal amphotericin B dose followed by standard itraconazole dosing. The recent evaluation of several antifungal options including isauvconazole in the treatment of coccidioidomycosis also show promise for additional therapeutic agents. A recently conducted trial has also shown the superiority of amphotericin B therapy over itraconazole in the treatment of talaromycosis. SUMMARY: The increased range of endemic mycoses coupled with the growing immunocompromised patient population mandates continued investigation of improved diagnostic and therapeutic options. Advances in these areas have led to more rapid diagnosis and more efficacious antifungal therapy.