Working group on the diagnosis and the epidemiology of endemic mycoses

Endemic mycoses are difficult to diagnose due to a lack of clinical awareness and sparse rapid diagnostic methods. Moreover, data concerning the epidemiology of these diseases are scarce and incomplete. The aim of this working group is the standardization and improvement of diagnostic tools for endemic mycoses and to achieve a consensus. As a result of that, a better management of patients and an improvement in the quality of the data concerning the epidemiology will be achieved. A second objective of the group will be to study the global epidemiology thanks to the participation of laboratories from endemic and non-endemic regions.

The diagnosis of endemic fungal infections classically relies on culture and microscopy. Both methods have limitations. Cultures are time-consuming and may be negative, especially in localized infections, delaying proper treatment and by this patient’s outcome. The diagnosis by microscopy requires skilled personnel as differential diagnosis may be difficult.

The aims of this working group will be:

1. To study and to compare in a multicenter study molecular diagnostic tools for endemic mycoses.

To develop a standard for these PCR methodologies and to validate this in clinical samples so that PCR could be incorporated into future consensus definitions for diagnosing endemic mycoses.

2. Prospective study on the sensitivity of different Histoplasma Ag test kits on serum.

Antigen detection is a promising tool for the diagnosis of histoplasmosis, especially in urine of immunosuppressed patients with disseminated disease. Outside the endemic areas most of the histoplasmosis cases occur in immunocompetent patients. Thus, prospectively investigate the performance of available antigen tests on serum from non-HIV patients will be a valuable addition.

3. Retrospective study of the epidemiology of endemic mycoses outside the America’s.

We first want to standardize the collection sheets of epidemiological data (including molecular) followed by a publication about epidemiological data of endemic mycoses in Europe.