Manglani Ravi, Pavosevic Helena Tomac, Han Liying, Epelbaum Oleg
Division of Pulmonary, Critical Care and Sleep Medicine, Westchester Medical Center, Valhalla, NY, USA.
Department of Pathology, Westchester Medical Center, Valhalla, NY, USA.
Respir Med Case Rep. 2020 May 30;30:101106. doi: 10.1016/j.rmcr.2020.101106. eCollection 2020.
The term "endemic mycoses" refers to a group of fungi that maintains a baseline rate of infection only in certain geographical regions due to the hospitable enviormental conditions these regions offer. In the United States, , , and are the three most prevalent endemic human fungal infections. The traditional endemic regions for these pathogens are defined based on data acquired many decades ago, and case detection is subject to diagnostic delays even in classically endemic areas, a problem that is likely to be magnified in areas less familiar with these fungal infections. The present series includes an example of each of these infections diagnosed in a medical center situated in the suburbs of New York City, a location not considered endemic for any of them. Likely routes of acquisition for the three patients are considered, and the history of encounters with these pathogens in New York State is briefly recounted. Altogether, this report is intended to serve as a reminder to clinicians that traditional distribution maps for the endemic mycoses are bound to be outdated in the face of modern trends in globalization, population dynamics, and ecological change.
“地方性真菌病”一词指的是一组真菌，由于某些地理区域提供适宜的环境条件，这些真菌仅在这些区域维持一定的感染基线率。在美国， 、 和 是三种最常见的人类地方性真菌感染。这些病原体的传统流行区域是根据几十年前获得的数据定义的，即使在典型的流行地区，病例检测也存在诊断延迟的问题，在对这些真菌感染不太熟悉的地区，这个问题可能会更加严重。本系列包括在纽约市郊区的一个医疗中心诊断出的每一种此类感染的病例，该地点不被认为是其中任何一种感染的流行地区。考虑了这三名患者可能的感染途径，并简要叙述了纽约州与这些病原体接触的历史。总之，本报告旨在提醒临床医生，面对全球化、人口动态和生态变化的现代趋势，地方性真菌病的传统分布图必然会过时。
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