Wagner Gernot, Moertl Deddo, Glechner Anna, Mayr Verena, Klerings Irma, Zachariah Casey, Van den Nest Miriam, Gartlehner Gerald, Willinger Birgit
Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Strasse 30, 3500 Krems, Austria.
Clinical Department of Internal Medicine III, University Hospital St. Poelten, Karl Landsteiner University of Health Sciences, Dunant-Platz 1, 3100 St. Poelten, Austria.
J Fungi (Basel). 2021 Feb 23;7(2):157. doi: 10.3390/jof7020157.
Paracoccidioidomycosis is a systemic mycosis that is endemic in geographical regions of Central and South America. Cases that occur in nonendemic regions of the world are imported through migration and travel. Due to the limited number of cases in Europe, most physicians are not familiar with paracoccidioidomycosis and its close clinical and histopathological resemblance to other infectious and noninfectious disease. To increase awareness of this insidious mycosis, we conducted a systematic review to summarize the evidence on cases diagnosed and reported in Europe. We searched PubMed and Embase to identify cases of paracoccidioidomycosis diagnosed in European countries. In addition, we used Scopus for citation tracking and manually screened bibliographies of relevant articles. We conducted dual abstract and full-text screening of references yielded by our searches. To identify publications published prior to 1985, we used the previously published review by Ajello et al. Overall, we identified 83 cases of paracoccidioidomycosis diagnosed in 11 European countries, published in 68 articles. Age of patients ranged from 24 to 77 years; the majority were male. Time from leaving the endemic region and first occurrence of symptoms considerably varied. Our review illustrates the challenges of considering systemic mycosis in the differential diagnosis of people returning or immigrating to Europe from endemic areas. Travel history is important for diagnostic-workup, though it might be difficult to obtain due to possible long latency period of the disease.
副球孢子菌病是一种系统性真菌病，在中美洲和南美洲的地理区域呈地方流行。在世界非流行地区发生的病例是通过移民和旅行输入的。由于欧洲的病例数量有限，大多数医生不熟悉副球孢子菌病及其与其他感染性和非感染性疾病在临床和组织病理学上的相似之处。为了提高对这种隐匿性真菌病的认识，我们进行了一项系统综述，以总结欧洲诊断和报告病例的证据。我们检索了PubMed和Embase，以确定在欧洲国家诊断出的副球孢子菌病病例。此外，我们使用Scopus进行引文追踪，并人工筛选相关文章的参考文献。我们对检索得到的参考文献进行了双盲摘要和全文筛选。为了识别1985年之前发表的文献，我们使用了Ajello等人之前发表的综述。总体而言，我们在68篇文章中确定了11个欧洲国家诊断出的83例副球孢子菌病病例。患者年龄在24岁至77岁之间；大多数为男性。从离开流行地区到首次出现症状的时间差异很大。我们的综述说明了在对从流行地区返回或移民到欧洲的人进行鉴别诊断时考虑系统性真菌病的挑战。旅行史对诊断检查很重要，尽管由于疾病可能的长潜伏期，可能难以获取。
