Cryptococcosis is well known as a complication of HIV/AIDS, but it can also affect those who are immunosuppressed for other reasons. Dr Marr and colleagues describe a set of 138 patients from the US. Around half (49%) had CNS involvement but only just over a quarter (27.8%) had a fever.
Blastomycosis is a rare fungal infection caused by inhaling spores of the fungus Blastomyces dermatitidis
Histoplasmosis is a fungal infection endemic to areas of Central America and Midwest USA. Most people develop a mild form of infection and are asymptomatic; if symptoms do occur they are usually flu-like, but can vary greatly. In a few, usually immunosuppressed, patients the disease can progress to life-threatening, disseminated histoplasmosis. Dr Thais Pincelli and colleagues recently reviewed all 10 cases of oropharyngeal histoplasmosis identified over a 21 year period at the Mayo Clinic in Rochester, Minnesota.
Safety and tolerability data for long-term use of fluconazole are scarce. Dr Davis and colleagues have published a study of 124 coccidioidomycosis patients in California and found that around half (52%) experienced significant side effects, in particular dry skin, hair loss and fatigue.
An evaluation of a qPCR test for Coccidioides showed good sensitivity (74%) and specificity (100%), and produced results within 4 hours – outperforming fungal culture.