Schwartz Ilan S, Kenyon Chris, Thompson George R
1Departments of Internal Medicine and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba Canada.
2Epidemiology for Global Health Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Curr Clin Microbiol Rep. 2016;3(2):71-80. doi: 10.1007/s40588-016-0034-6. Epub 2016 Mar 18.
Infections with geographically constrained dimorphic fungi cause the endemic mycoses, which include blastomycosis, coccidioidomycosis, emmonsiosis, histoplasmosis, paracoccidioidomycosis, sporotrichosis, and penicilliosis. In the last 5 years, our understanding of the epidemiology, diagnostics, and to a lesser extent management of these diseases has advanced. Specifically, the application of molecular techniques for genotyping fungal pathogens has resulted in the recognition of cryptic species within several genera, including , and ; the reclassification of , the agent of penicilliosis, to the genus ; and the global emergence of dimorphic fungi of the genus , cause disease in immunocompromised persons. New and refined diagnostic tests are available based on the detection of circulating antigens and antibodies, mass spectrometry, and targeted gene amplification. In contrast, the development of new therapeutic options remains stalled, although isavuconazole may hold promise. Finally, advances have been made in the prospect of viable vaccines for preventing animal and human disease.
感染受地理限制的双相真菌会引发地方性真菌病，其中包括芽生菌病、球孢子菌病、埃蒙斯菌病、组织胞浆菌病、副球孢子菌病、孢子丝菌病和青霉病。在过去5年中，我们对这些疾病的流行病学、诊断以及在较小程度上对其管理的认识有了进展。具体而言，应用分子技术对真菌病原体进行基因分型已导致在几个属中识别出隐性物种，包括 、 和 ；将青霉病病原体 重新分类到 属；以及 属双相真菌在全球出现，在免疫功能低下者中引起疾病。基于循环抗原和抗体检测、质谱分析和靶向基因扩增，有了新的和改进的诊断测试。相比之下，新治疗选择的开发仍然停滞不前，尽管艾沙康唑可能有前景。最后，在预防动物和人类疾病的可行疫苗方面取得了进展。
