MMWR Morb Mortal Wkly Rep. 2024 Mar 21;73(11):239-244. doi: 10.15585/mmwr.mm7311a2.
Coccidioidomycosis, histoplasmosis, and blastomycosis are lower respiratory tract fungal infections whose signs and symptoms can resemble those of other respiratory illnesses, including pneumonia caused by bacterial or viral etiologies; this overlap in clinical presentation might lead to missed or delayed diagnoses. The causative fungi live in the environment, often in soil or plant matter. To describe the epidemiologic characteristics of cases of coccidioidomycosis, histoplasmosis, and blastomycosis during the COVID-19 pandemic, CDC analyzed case surveillance data for 2019-2021. During this period, a total of 59,655 coccidioidomycosis cases, 3,595 histoplasmosis cases, and 719 blastomycosis cases were reported to CDC. In 2020, fewer cases of each disease occurred in spring compared with other seasons, and most cases occurred in fall; national seasonality is not typically observed, and cases were seasonally distributed more evenly in 2019 and 2021. Fewer cases coinciding with the start of the COVID-19 pandemic, along with an unusually high blastomycosis case fatality rate in 2021 (17% compared with more typical rates of 8%-10%), suggest that the pandemic might have affected patients' health care-seeking behavior, public health reporting practices, or clinical management of these diseases. Increased awareness and education are needed to encourage health care providers to consider fungal diseases and to identify pneumonia of fungal etiology. Standardized diagnostic guidance and informational resources for fungal testing could be incorporated into broader respiratory disease awareness and preparedness efforts to improve early diagnosis of coccidioidomycosis, histoplasmosis, and blastomycosis.
球孢子菌病、组织胞浆菌病和芽生菌病是下呼吸道真菌感染，其症状和体征可能与其他呼吸道疾病相似，包括由细菌或病毒病因引起的肺炎；临床表现的这种重叠可能导致漏诊或延迟诊断。致病真菌存在于环境中，通常在土壤或植物物质中。为了描述 COVID-19 大流行期间球孢子菌病、组织胞浆菌病和芽生菌病的流行病学特征，CDC 分析了 2019-2021 年的病例监测数据。在此期间，共向 CDC 报告了 59655 例球孢子菌病病例、3595 例组织胞浆菌病病例和 719 例芽生菌病病例。2020 年，与其他季节相比，春季每种疾病的病例都较少，大多数病例发生在秋季；通常不会出现全国性季节性，2019 年和 2021 年病例的季节性分布更加均匀。与 COVID-19 大流行开始时同时发生的病例较少，以及 2021 年芽生菌病的病死率异常高（17%，而更典型的病死率为 8%-10%），这表明大流行可能影响了患者的医疗保健寻求行为、公共卫生报告实践或这些疾病的临床管理。需要提高认识和教育，以鼓励医疗保健提供者考虑真菌感染疾病，并识别真菌性病因引起的肺炎。可以将标准化诊断指南和真菌检测信息资源纳入更广泛的呼吸道疾病意识和准备工作中，以提高球孢子菌病、组织胞浆菌病和芽生菌病的早期诊断率。
