Endemic Fungal Infection

Endemic fungi (EF) live in soil as saprophytes, infect humans when their spores are inhaled, and often affect healthy individuals that live in or have visited certain areas. EF infection should be suspected in patients from endemic areas who present with pulmonary opacities and/or cavitary disease on imaging. However, disseminated life-threatening disease may affect also immunocompromised patients (e.g. AIDS). Consider EF infection in patients with bronchopneumonia associated with lymphadenopathy that does not respond to antibiotics. Fungal infection may mimic tuberculosis, metastatic disease, lung cancer. Immunosupression is frequently associated with disseminated EF infection. Chronic mediastinal histoplasmosis is a common benign etiology of superior vena cava syndrome.