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Wagner G, Moertl D, Glechner A, Mayr V, Klerings I, Zachariah C, Van den Nest M, Gartlehner G, Willinger B. Paracoccidioidomycosis Diagnosed in Europe-A Systematic Literature Review. J Fungi (Basel) 2021; 7:157. [PMID: 33672212 PMCID: PMC7926554 DOI: 10.3390/jof7020157] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 11/19/2022] Open
Abstract
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.
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Affiliation(s)
- Gernot Wagner
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Strasse 30, 3500 Krems, Austria; (A.G.); (V.M.); (I.K.); (C.Z.); (G.G.)
| | - Deddo Moertl
- Clinical Department of Internal Medicine III, University Hospital St. Poelten, Karl Landsteiner University of Health Sciences, Dunant-Platz 1, 3100 St. Poelten, Austria;
| | - Anna Glechner
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Strasse 30, 3500 Krems, Austria; (A.G.); (V.M.); (I.K.); (C.Z.); (G.G.)
| | - Verena Mayr
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Strasse 30, 3500 Krems, Austria; (A.G.); (V.M.); (I.K.); (C.Z.); (G.G.)
| | - Irma Klerings
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Strasse 30, 3500 Krems, Austria; (A.G.); (V.M.); (I.K.); (C.Z.); (G.G.)
| | - Casey Zachariah
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Strasse 30, 3500 Krems, Austria; (A.G.); (V.M.); (I.K.); (C.Z.); (G.G.)
| | - Miriam Van den Nest
- Department for Infection Control and Hospital Epidemiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;
| | - Gerald Gartlehner
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Strasse 30, 3500 Krems, Austria; (A.G.); (V.M.); (I.K.); (C.Z.); (G.G.)
- RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709-2194, USA
| | - Birgit Willinger
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;
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Köhler C, Klotz M, Daus H, Schwarze G, Dette S. Viszerale Paracoccidioidomykose bei einem Goldgräber aus Brasilien*. Mycoses 2009. [DOI: 10.1111/j.1439-0507.1988.tb04440.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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