Emmonsiosis

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Emmonsiosis
Other namesEmergomycosis [1]
Specialty Infectious diseases [2]
Symptoms Skin rash [2]
CausesEmergomyces, previously classified under genus Emmonsia [3]
Risk factors HIV, organ transplant, steroid use. [1]
Diagnostic method skin biopsy, histopathology [1]
Differential diagnosis Histoplasmosis [1]
Treatment Antifungals
Medication Amphotericin B [1]
FrequencyRare [1]

Emmonsiosis, also known as emergomycosis, is a systemic fungal infection that can affect the lungs, generally always affects the skin and can become widespread. [1] [2] The lesions in the skin look like small red bumps and patches with a dip, ulcer and dead tissue in the centre. [4]

Contents

It is caused by the Emergomyces species, a novel dimorphic fungus, previously classified under the genus Emmonsia . [3] These fungi are found in soil and transmitted by breathing in its spores from the air. [1] Inside the body it converts to yeast-like cells which then cause disease and invade beyond the lungs. [1] Diagnosis is by skin biopsy and its appearance under the microscope. [5] It is difficult to distinguish from histoplasmosis. [3] [6] Treatment is usually with amphotericin B. [3]

Emmonsiosis can be fatal. [3] The disseminated type is more prevalent in South Africa, particularly in people with HIV. [3]

Signs and symptoms

Generally, all cases have involvement of the skin. [5] The lesions look like small red bumps and patches with a dip, ulcer and dead tissue in the centre. [4] There may be several lesions and their distribution can be widespread. [1] The lungs may be affected. [3] [4]

Cause

It is caused by the Emergomyces species, a novel dimorphic fungus, previously classified under the genus Emmonsia . [3] [7] Following a revised taxonomy in 2017 based on DNA sequence analyses, five of these Emmonsia-like fungi have been placed under the separate genus Emergomyces. [3] These include Emergomyces pasteurianus, Emergomyces africanus, Emergomyces canadensis, Emergomyces orientalis and Emergomyces europaeus. [3] [8]

Emergomyces africanus was previously known as Emmonsia africanus , which has similar features to Histoplasma spp. and the family of Ajellomycetaceae. [6]

The disease has been observed among people who have a weakened immune system and risk factors include HIV, organ transplant and steroid use. [1] [3]

Mechanism

The fungus is found in soil and is released in the air. [1] Transmission is by breathing in fungal spores from the air. [1] Inside the body it converts to yeast-like cells which then cause disease and invade beyond the lungs. [1] In people with HIV, Emmonsiosis has been associated with Immune reconstitution inflammatory syndrome following initiating antiretroviral treatment. [1]

Diagnosis

Diagnosis is by skin biopsy and its appearance under the microscope. [5]

Differential diagnosis

Generally, it is difficult to distinguish from histoplasmosis. [6] Other conditions that appear similar include tuberculosis, [5] blastomycosis, sporotrichosis, chicken pox, Kaposi's sarcoma and drug reactions. [4]

Treatment

Treatment usually includes amphotericin B. [3]

Prognosis

It can be fatal. [5]

Epidemiology

The disseminated type is more prevalent in South Africa, particularly in people with HIV. [5]

History

The disease was thought to be a rare condition of the lung. [2] Early cases may have been misdiagnosed as histoplasmosis. [6]

Other animals

The genus Emmonsia can cause adiaspiromycosis, a lung disease in wild animals. [9]

Related Research Articles

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<span class="mw-page-title-main">Cryptococcosis</span> Potentially fatal fungal disease

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<span class="mw-page-title-main">Blastomycosis</span> Medical condition

Blastomycosis or blasto is a fungal infection caused by inhaling spores of a Blastomyces fungus. Only about half of people with the disease have symptoms, which can include fever, cough, night sweats, muscle pains, weight loss, chest pain, and feeling tired. Symptoms usually develop between three weeks and three months after breathing in the spores. Most blastomycosis infections affect the lungs. In 25 to 40% of cases, the infection also spreads to other parts of the body, such as the skin, bones or central nervous system. Although blastomycosis is especially dangerous for those with weak immune systems, most people diagnosed with blastomycosis have healthy immune systems.

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<span class="mw-page-title-main">Pneumocystosis</span> Medical condition

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<span class="mw-page-title-main">Sporotrichosis</span> Medical condition

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<span class="mw-page-title-main">Paracoccidioidomycosis</span> Medical condition

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<span class="mw-page-title-main">Basidiobolomycosis</span> Medical condition

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<i>Histoplasma capsulatum</i> Species of fungus

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<i>Blastomyces dermatitidis</i> Species of fungus

Blastomyces dermatitidis is a dimorphic fungus that causes blastomycosis, an invasive and often serious fungal infection found occasionally in humans and other animals. It lives in soil and wet, decaying wood, often in an area close to a waterway such as a lake, river or stream. Indoor growth may also occur, for example, in accumulated debris in damp sheds or shacks. The fungus is endemic to parts of eastern North America, particularly boreal northern Ontario, southeastern Manitoba, Quebec south of the St. Lawrence River, parts of the U.S. Appalachian mountains and interconnected eastern mountain chains, the west bank of Lake Michigan, the state of Wisconsin, and the entire Mississippi Valley including the valleys of some major tributaries such as the Ohio River. In addition, it occurs rarely in Africa both north and south of the Sahara Desert, as well as in the Arabian Peninsula and the Indian subcontinent. Though it has never been directly observed growing in nature, it is thought to grow there as a cottony white mold, similar to the growth seen in artificial culture at 25 °C (77 °F). In an infected human or animal, however, it converts in growth form and becomes a large-celled budding yeast. Blastomycosis is generally readily treatable with systemic antifungal drugs once it is correctly diagnosed; however, delayed diagnosis is very common except in highly endemic areas.

<span class="mw-page-title-main">Dimorphic fungus</span>

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