Saravanababu Tejaswini, Elsayed Sameer, Gupta Ruchika, Delport Johan, Rahimi Shahmirzadi Mohammedreza, AlMutawa Fatimah
Department of Biology, Faculty of Science, Western University, London, ON N6A 3K7, Canada.
Department of Infectious Diseases, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada.
J Fungi (Basel). 2025 Aug 12;11(8):589. doi: 10.3390/jof11080589.
Blastomycosis, caused by dimorphic fungi of the genus, is endemic to regions in North America, including the Great Lakes and other parts of Canada and the United States of America. The infection primarily occurs through the inhalation of airborne conidia from contaminated soil and decaying organic matter. Pulmonary involvement is most common, but dissemination to other organs such as the skin and bones can occur, especially in immunocompromised individuals. Diagnosis is challenging due to its clinical overlap with other diseases. Culture remains the gold-standard diagnostic method, but is time-consuming, with sensitivity ranging from 66.4% to 86%. Tissue histopathology offers quicker results but has sensitivities ranging from 36% to 85%. Antigen detection assays show high sensitivity from 76.3% to 91.3% but suffer from cross-reactivity with other fungi. PCR methods offer high specificity, with sensitivity ranging from 67.6% to 100%. In immunocompromised patients, blastomycosis is often more severe, with a mortality rate exceeding 30%. Multi-modal diagnostic approaches are crucial for accurate detection and management.
芽生菌病由该属双相真菌引起，在北美洲的一些地区呈地方性流行，包括五大湖地区以及加拿大和美利坚合众国的其他部分地区。感染主要通过吸入来自受污染土壤和腐烂有机物的空气传播分生孢子而发生。肺部受累最为常见，但也可扩散至其他器官，如皮肤和骨骼，尤其是在免疫功能低下的个体中。由于其临床表现与其他疾病重叠，诊断具有挑战性。培养仍然是金标准诊断方法，但耗时较长，敏感性在66.4%至86%之间。组织组织病理学结果出得更快，但敏感性在36%至85%之间。抗原检测试验显示出较高的敏感性，在76.3%至91.3%之间，但与其他真菌存在交叉反应。聚合酶链反应（PCR）方法具有高特异性，敏感性在67.6%至100%之间。在免疫功能低下的患者中，芽生菌病通常更为严重，死亡率超过30%。多模式诊断方法对于准确检测和管理至关重要。
