受地理限制的双态真菌感染会导致地方性真菌病,其中包括芽生菌病,球孢子菌病,emmonsiosis,组织胞浆菌病,副角菌病,孢子丝菌病,和青霉病。在过去的5年里,我们对流行病学的理解,诊断,在较小程度上,这些疾病的管理已经进步。具体来说,对真菌病原体进行基因分型的分子技术的应用导致了对几个属内的隐匿物种的识别,包括胚芽,和副球菌;马尔尼菲青霉菌的重新分类,青霉病的药剂,Talaromyces属;以及Emmonsia属双态真菌的全球出现,在免疫功能低下的人中引起疾病。基于循环抗原和抗体的检测,可提供新的和完善的诊断测试,质谱,和靶向基因扩增。相比之下,新的治疗方案的开发仍然停滞不前,虽然伊沙武康唑可能有希望。最后,在预防动物和人类疾病的可行疫苗的前景方面取得了进展。
Infections with geographically constrained dimorphic fungi cause the endemic mycoses, which include blastomycosis, coccidioidomycosis,
emmonsiosis, histoplasmosis, paracoccidioidomycosis, sporotrichosis, and penicilliosis. In the last 5 years, our understanding of the epidemiology, diagnostics, and to a lesser extent management of these diseases has advanced. Specifically, the application of molecular techniques for genotyping fungal pathogens has resulted in the recognition of cryptic species within several genera, including Blastomyces, and Paracoccidioides; the reclassification of Penicillium marneffei, the agent of penicilliosis, to the genus Talaromyces; and the global emergence of dimorphic fungi of the genus Emmonsia, cause disease in immunocompromised persons. New and refined diagnostic tests are available based on the detection of circulating antigens and antibodies, mass spectrometry, and targeted gene amplification. In contrast, the development of new therapeutic options remains stalled, although isavuconazole may hold promise. Finally, advances have been made in the prospect of viable vaccines for preventing animal and human disease.