Analysis and Forecast of the Spread of Particularly Dangerous Mycoses around the World

The literature review presents an analysis of publications over the past five years on the global distribution of particularly dangerous (endemic) mycoses: coccidioidomycosis, histoplasmosis, blastomycosis, paracoccidioidomycosis. The causative agents of these mycoses are dimorphic micromycetes, which can cause a severe course of the disease, even death. These fungi exist in specific ecological niches, but in recent years there have been many reports of them occurring outside of regions of traditionally known endemicity. There are potential causes for these changes, such as global factors (climate change, migration) and extensive use of immunosuppressive drugs. Climate warming may provide favorable conditions for the growth of Coccidioides spp. in new areas, while prolonged dry spells and subsequent dust storms result in increased incidence of coccidioidomycosis in already established endemic areas. Currently, there is an assumption that not only the soil, but also rodents are the primary reservoir of Coccidioides in the external environment. Histoplasmosis is endemic in the countries of the Americas, but the extent of spread of the causative agents has not been fully defined. In Latin America, histoplasmosis is one of the most common infections in HIV-infected people, with a high mortality rate. Many epidemiological data on blastomycosis come from North America, with less information from Africa and Asia. Cases of endemic mycoses in immunocompetent travelers are usually diagnosed incorrectly, due to the absence of specific symptoms. There is also a risk of reactivation of infection in persons with acquired immunosuppression, even after a long period of time. Isolation of pathogens from environmental objects using conventional cultural methods is difficult, while the introduction of molecular-genetic studies will supplement the knowledge about the epidemiology of these mycoses.