Recommendations for Diagnosing Pneumonia Caused by Endemic Mycoses

While not uncommon within their geographic niches, the endemic mycoses histoplasmosis, blastomycosis, and coccidioidomycosis are infrequently included by clinicians when diagnosing cases of community-acquired pneumonia (CAP). Moreover, the diagnosis can be challenging due to lack of test availability, standardization, and clinical interpretation. Therefore, the authors performed a literature review to assess the available diagnostic tests for these three mycoses. In addition, feedback was sought from 12 clinical experts regarding testing recommendations and algorithms.

Testing for endemic mycoses is generally suggested for all individuals with CAP who reside in (or have recently visited) the endemic areas if such patients fail to respond to …