Endemic systemic mycoses: coccidioidomycosis, histoplasmosis, paracoccidioidomycosis and blastomycosis

J Dtsch Dermatol Ges. 2011 Sep;9(9):705-14; quiz 715. doi: 10.1111/j.1610-0387.2011.07731.x. Epub 2011 Jul 4.
[Article in English, German]


Endemic deep or systemic mycoses are common in specific geographical areas of the world. Coccidioidomycosis is present in semi-desert areas, histoplasmosis and paracoccidioidomycosis in tropical regions and blastomycosis belongs to temperate climates. The two former are widely distributed in the American continent and some tropical regions of the world; the third is limited to Central and South America, and the last to North America and Central and East Africa. These mycoses all have a similar pathogenesis, as the inoculum enters the host through the respiratory tract. Cutaneous manifestations are secondary to lymphatic and hematogenous dissemination. These deep mycoses are exceptional in Europe. Most cases are observed in returning travelers from endemic areas, aid workers, archaeologists, speleologist and immigrants. However, there have been some autochthonous cases of histoplasmosis due to Histoplasma capsulatum var. capsulatum reported in European countries such as Italy and Germany. In this article, we provide up-to-date epidemiological, clinical, diagnostic and therapeutic data on the four most important imported systemic mycoses in Europe.

Publication types

  • Review

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis
  • AIDS-Related Opportunistic Infections / drug therapy
  • AIDS-Related Opportunistic Infections / epidemiology
  • Antifungal Agents / administration & dosage
  • Blastomycosis / diagnosis
  • Blastomycosis / drug therapy
  • Blastomycosis / epidemiology
  • Coccidioidomycosis / diagnosis
  • Coccidioidomycosis / drug therapy
  • Coccidioidomycosis / epidemiology
  • Cross-Sectional Studies
  • Dermatomycoses / diagnosis
  • Dermatomycoses / drug therapy
  • Dermatomycoses / epidemiology*
  • Diagnosis, Differential
  • Endemic Diseases / statistics & numerical data*
  • Histoplasmosis / diagnosis
  • Histoplasmosis / drug therapy
  • Histoplasmosis / epidemiology
  • Humans
  • Incidence
  • Lung Diseases, Fungal / diagnosis
  • Lung Diseases, Fungal / drug therapy
  • Lung Diseases, Fungal / epidemiology*
  • Paracoccidioidomycosis / diagnosis
  • Paracoccidioidomycosis / drug therapy
  • Paracoccidioidomycosis / epidemiology


  • Antifungal Agents