Histoplasmosis and other Endemic Fungal Infections

Endemic mycoses are invasive fungal infections endemic to certain geographical areas. Although more severe in immunocompromised hosts, the endemic mycoses commonly affect immunocompetent hosts as well; thus, travelers to endemic areas may acquire these infections. The most common endemic mycosis reported in travelers is histoplasmosis, usually acquired during visits to Latin America. Clusters as well as sporadic cases have been reported among returning travelers. Coccidiodomycosis is reported mainly in travelers returning from Arizona and California. Other endemic mycoses are rarely reported in travelers. This chapter reviews the epidemiology, clinical features, diagnosis, and treatment of the endemic mycoses from the point of view of the clinician in a nonendemic location whose patients include returning travelers.