ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
The Geographic Distribution of Dimorphic Mycoses in the United States for the Modern Era.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers.
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Who cites it
71 citing papers in PubMed, 105 citations in OpenAlex.
- Fosmanogepix Treatment for Coccidioidomycosis Under an Expanded Access Program.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Off the Map: A Ten-Year Review of Coccidioidomycosis in Southeastern Michigan.Journal of fungi (Basel, Switzerland) · 2026Article
- Manogepix demonstrates potentAntimicrobial agents and chemotherapy · 2026Article
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- Trends in Incidence and Risk Factors of HIV-Associated Disseminated Histoplasmosis in the Americas: An Observational Cohort Study.Journal of the International AIDS Society · 2026Observational
- Demographics and Geographic Accessibility of Invasive Fungal Infection Clinical Trial Sites.JAMA network open · 2026Article
- New 2030 Global Targets for Histoplasmosis from International Society for Human and Animal Mycology (ISHAM) 2025 Histoplasmosis Working Group.Emerging infectious diseases · 2026Article
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- Mixed mycotic infection in an immunocompromised host with advanced HIV diagnosed with the assistance of a Karius test.Medical mycology case reports · 2026Article
- Review
- Histoplasmosis with mediastinal lymphadenopathy in an immunocompetent municipal water department employee in Texas: a case report.Frontiers in cellular and infection microbiology · 2026Article
- Updating the Epidemiology of Blastomycosis and Histoplasmosis in the United States, Using National Electronic Health Record Data, 2013-2023.The Journal of infectious diseases · 2025Article
- Real-world Evaluation of Histoplasmosis Diagnosis and Treatment in Patients From a Michigan Health System.Open forum infectious diseases · 2025Article
- Presence of Microorganisms in the Environment: One Health Approach.Microorganisms · 2025Review
- Mapping the Geographic Distribution of Dimorphic Mycoses Using a US Commercial Insurance Database.Open forum infectious diseases · 2025Article
- Progressive Disseminated Histoplasmosis with Dermatomyositis and Macrophage Activation Syndrome/Hemophagocytic Lymphohistiocytosis.The American journal of tropical medicine and hygiene · 2025Article
- Clinical and Laboratory Features of Hemophagocytic Lymphohistiocytosis in People With Disseminated Histoplasmosis.Open forum infectious diseases · 2025Article
- Endemic Mycoses for Pulmonary Clinicians: From Nodules to ARDS.CHEST pulmonary · 2025Review
- Longitudinal assessment of the effect of invasive fungal infections on transplant success in kidney transplant recipients.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2025Article
- Assessment of Prior Infection With Histoplasmosis Using Skin Test and Serological Surveys: A Global Systematic Review.Open forum infectious diseases · 2025Review
11 more citing papers are in PubMed but not listed here.
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe dimorphic mycoses (DMs) of the United States-Histoplasma, Coccidioides, and Blastomyces-commonly known as endemic mycoses of North America (in addition to Paracoccidioides) are increasingly being diagnosed outside their historical areas of endemicity. Despite this trend, the maps outlining their geographic distributions have not been updated in more than half a century using a large, nationwide database containing individual-patient-level data.
methodsThis was a retrospective analysis of >45 million Medicare fee-for-service beneficiaries from 1 January 2007 through 31 December 2016. Diagnoses of histoplasmosis, coccidioidomycosis, and blastomycosis were defined by International Classification of Diseases, Ninth/10th Revision, codes. The primary outcome was the incidence of histoplasmosis, coccidioidomycosis, and blastomycosis for each US county. Clinically meaningful thresholds for incidence were defined as 100 cases/100 000 person-years for histoplasmosis and coccidioidomycosis and 50 cases/100 000 person-years for blastomycosis.
resultsThere were 79 749 histoplasmosis, 37 726 coccidioidomycosis, and 6109 blastomycosis diagnoses in unique persons from 2007-2016 across 3143 US counties. Considering all US states plus Washington, DC, 94% (48/51) had ≥1 county above the clinically relevant threshold for histoplasmosis, 69% (35/51) for coccidioidomycosis, and 78% (40/51) for blastomycosis.
conclusionsPersons with histoplasmosis, coccidioidomycosis, and blastomycosis are diagnosed in significant numbers outside their historical geographic distributions established >50 years ago. Clinicians should consider DM diagnoses based on compatible clinical syndromes with less emphasis placed on patients' geographic exposure. Increased clinical suspicion leading to a subsequent increase in DM diagnostic testing would likely result in fewer missed diagnoses, fewer diagnostic delays, and improved patient outcomes.
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