Outdated maps of disease-causing fungi may lead to delayed and missed diagnoses. Fungi in the soil cause a significant number of serious lung infections in 48 out of 50 states and the District of Columbia, including many areas long thought to be free of deadly environmental fungi. This is according
The fungus Histoplasma, which causes lung infections, was concentrated in the Midwest in the 1950s and 60s , but now causes significant disease throughout much of the country . Researchers at Washington University School of Medicine in St. Louis discovered that the three main kinds of soil fungi that cause lung infections have all expanded their ranges in recent decades. Reliance on outdated maps could be causing delayed or missed diagnoses.
“Every few weeks I get a call from a doctor in the Boston area – a different doctor every time – about a case they can’t solve,” said senior author Andrej Spec, MD, an associate professor of medicine and a specialist in fungal infections. “They always start by saying, ‘We don’t have histo here, but it really kind of looks like histo.’ I say, ‘You guys call me all the time about this. You, or histo, is one of the three main species of soil fungi that cause lung infections in the U.S.
The three main species of fungi that cause lung infections in the U.S. — Histoplasma , Blastomyces and Coccidioides — have all expanded their ranges in recent decades. These maps were created based on data from 1955 and 2007-2016 . Reliance on outdated maps may lead to delayed or missed diagnoses. Credit: Patrick Mazi and Andrej Spec/Washington University
“People with fungal lung infection often spend weeks trying to get the right diagnosis and appropriate treatment, and the whole time they’re feeling terrible,” said lead author Patrick B. Mazi, MD, a clinical fellow in infectious diseases. “They usually have multiple healthcare visits with multiple opportunities for testing and diagnosis, but the doctor just doesn’t consider a fungal infection until they’ve exhausted all other possibilities.
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