Current Fungal Infection Reports

, Volume 7, Issue 4, pp 311–319 | Cite as

Fungal Infections Associated with Travel

  • Clémence Richaud
  • David Lebeaux
  • Olivier Lortholary
Epidemiological Aspects of Fungal Infection (T Chiller and J Baddley, Section Editors)

Abstract

International travel is increasing. As fungal infections associated with travel are rare diseases, they are often underestimated and misdiagnosed. Thus, updated knowledge in this area is of key importance for physicians not only for pretravel counselling but also for the management of patients upon their return. We present an update of data published in 2012 and 2013. We present an overview of epidemiological changes, especially new endemic areas, and the implications of climate and natural disasters. Through experimental and clinical data, new insights into the pathophysiology of fungal infections associated with travel have been obtained, especially for Cryptococcus spp. Recently published diagnostic tools could lead to faster and more accurate diagnosis. Lastly, recent prognostic and therapeutic data are emphasized.

Keywords

Travel Immunodeficiency Cryptococcus Coccidioides Basidiobolus Penicillium marneffei Histoplasma 

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    • United Nations World Tourism Organization. Tourism Highlights, 2013 Edition. http://mkt.unwto.org/en/publication/unwto-tourism-highlights-2013-edition. Very informative about tourism data.
  2. 2.
    •• Lortholary O, Charlier C, Lebeaux D, Lecuit M, Consigny PH. Fungal infections in immunocompromised travelers. Clin Infect Dis. 2012;56(6):861–9. Review about immunocompromised traveler with useful diagnostic scheme.PubMedCrossRefGoogle Scholar
  3. 3.
    • Leder K, Torresi J, Libman MD, et al. GeoSentinel surveillance of illness in returned travelers, 2007–2011. Ann Intern Med. 2013;158(6):456–68. Study with some recruitment bias but which provides information about ill returning travellers.PubMedCrossRefGoogle Scholar
  4. 4.
    • Meece JK, Anderson JL, Gruszka S, Sloss BL, Sullivan B, Reed KD. Variation in clinical phenotype of human infection among genetic groups of Blastomyces dermatitidis. J Infect Dis. 2013;207(5):814–22. Advances in research on virulence mechanisms in fungi.PubMedCrossRefGoogle Scholar
  5. 5.
    • Chang P, Rodas C. Skin lesions in histoplasmosis. Clin Dermatol. 2012;30(6):592–8. Dermatological aspects of histoplasmosis.PubMedCrossRefGoogle Scholar
  6. 6.
    •• Byrnes 3rd EJ, Li W, Ren P, et al. A diverse population of Cryptococcus gattii molecular type VGIII in southern Californian HIV/AIDS patients. PLoS Pathog. 2013;7(9):e1002205. A seminal study on pathogeny of C. gattii.CrossRefGoogle Scholar
  7. 7.
    •• Chen SC, Korman TM, Slavin MA, et al. Antifungal therapy and management of complications of cryptococcosis due to Cryptococcus gattii. Clin Infect Dis. 2013;57(4):543–51. Very informative study of the demographics, clinical data, outcome and treatment of C. gattii.PubMedCrossRefGoogle Scholar
  8. 8.
    •• Chen SC, Slavin MA, Heath CH, et al. Clinical manifestations of Cryptococcus gattii infection: determinants of neurological sequelae and death. Clin Infect Dis. 2012;55(6):789–98. Very informative study of the demographics, clinical data, outcome and treatment of C. gattii.PubMedCrossRefGoogle Scholar
  9. 9.
    Vikram HR, Smilack JD, Leighton JA, Crowell MD, De Petris G. Emergence of gastrointestinal basidiobolomycosis in the United States, with a review of worldwide cases. Clin Infect Dis. 2012;54(12):1685–91.PubMedCrossRefGoogle Scholar
  10. 10.
    Theodoro RC, Teixeira MM, Felipe MS, et al. Genus paracoccidioides: species recognition and biogeographic aspects. PLoS One. 2012;7(5):e37694.PubMedCrossRefGoogle Scholar
  11. 11.
    •• Fisher MC, Henk DA, Briggs CJ, et al. Emerging fungal threats to animal, plant and ecosystem health. Nature. 2012;484(7393):186–94. Very comprehensive review on interactions between fungal disease and ecosystems.PubMedCrossRefGoogle Scholar
  12. 12.
    • Systemic mycoses. Clin Dermatol. 2012;30(6):563–684. doi:10.1016/S0738-081X(12)00195-2. Special issue on dermatological involvement in deep mycosis.
  13. 13.
    • Subcutaneous mycoses. Clin Dermatol. 2012;30(4):367–468. doi:10.1016/S0738-081X(12)00088-0. Special issue on dermatological involvement in superficial mycosis.
  14. 14.
    • Smith JA, Kauffman CA. Pulmonary fungal infections. Respirology. 2012;17(6):913–26.PubMedCrossRefGoogle Scholar
  15. 15.
    Romeo O, Scordino F, Chillemi V, Criseo G. Cryptococcus neoformans/Cryptococcus gattii species complex in southern Italy: an overview on the environmental diffusion of serotypes, genotypes and mating-types. Mycopathologia. 2012;174(4):283–91.PubMedCrossRefGoogle Scholar
  16. 16.
    •• Hagen F, Colom MF, Swinne D, et al. Autochthonous and dormant Cryptococcus gattii infections in Europe. Emerg Infect Dis. 2012;18(10):1618–24. Comprehensive study about C. gattii infection in Europe and evidence of autochtonous strains.PubMedCrossRefGoogle Scholar
  17. 17.
    Permpalung N, Kaewpoowat Q, Prasidthrathsint K, Chongnarungsin D, Hyman CL. Pulmonary blastomycosis: a new endemic area in New York state. Mycoses. 2013. doi:10.1111/myc.12073.PubMedGoogle Scholar
  18. 18.
    Litvinov IV, St-Germain G, Pelletier R, Paradis M, Sheppard DC. Endemic human blastomycosis in Quebec, Canada, 1988–2011. Epidemiol Infect. 2013;141(6):1143–7.PubMedCrossRefGoogle Scholar
  19. 19.
    Centers for Disease Control and Prevention (CDC). Increase in reported coccidioidomycosis – United States, 1998–2011. MMWR Morb Mortal Wkly Rep. 2013;62(12):217–21.Google Scholar
  20. 20.
    Marsden-Haug N, Goldoft M, Ralston C, et al. Coccidioidomycosis acquired in Washington State. Clin Infect Dis. 2012;56(6):847–50.PubMedCrossRefGoogle Scholar
  21. 21.
    Brillhante RS, Moreira Filho RE, Rocha MF, et al. Coccidioidomycosis in armadillo hunters from the state of Ceara, Brazil. Mem Inst Oswaldo Cruz. 2012;107(6):813–5.PubMedCrossRefGoogle Scholar
  22. 22.
    Silva MB, Costa MM, Torres CC, et al. Urban sporotrichosis: a neglected epidemic in Rio de Janeiro, Brazil. Cad Saude Publica. 2012;28(10):1867–80.PubMedCrossRefGoogle Scholar
  23. 23.
    Calanni LM, Perez R, Brasili S, et al. Outbreak of histoplasmosis in Province of Neuquen, Patagonia Argentina. Rev Iberoam Micol. 2012. doi:10.1016/j.riam.2012.12.007.Google Scholar
  24. 24.
    Pan B, Chen M, Pan W, Liao W. Histoplasmosis: a new endemic fungal infection in China? review and analysis of cases. Mycoses. 2013;56(3):212–21.PubMedCrossRefGoogle Scholar
  25. 25.
    Hu Y, Zhang J, Li X, et al. Penicillium marneffei infection: an emerging disease in mainland China. Mycopathologia. 2013;175(1–2):57–67.PubMedCrossRefGoogle Scholar
  26. 26.
    Neblett Fanfair R, Benedict K, Bos J, et al. Necrotizing cutaneous mucormycosis after a tornado in Joplin, Missouri, in 2011. N Engl J Med. 2012;367(23):2214–25.PubMedCrossRefGoogle Scholar
  27. 27.
    • Cao C, Liang L, Wang W, et al. Common reservoirs for Penicillium marneffei infection in humans and rodents, China. Emerg Infect Dis. 2011;17(2):209–14. Very smart study with the aim of clarifying the physiopathology and natural cycle of P. marneffei.PubMedCrossRefGoogle Scholar
  28. 28.
    Chandran V, Sadanandan SM, Sobhanakumari K. Chromoblastomycosis in Kerala, India. Indian J Dermatol Venereol Leprol. 2012;78(6):728–33.PubMedCrossRefGoogle Scholar
  29. 29.
    Cordeiro Rde A, e Silva KR, Brilhante RS, et al. Coccidioides posadasii infection in bats, Brazil. Emerg Infect Dis. 2012;18(4):668–70.PubMedGoogle Scholar
  30. 30.
    Pal DK, Mallick AA, Majhi TK, Biswas BK, Chowdhury MK. Rhinosporidiosis in southwest Bengal. Trop Dr. 2012;42(3):150–3.CrossRefGoogle Scholar
  31. 31.
    Apisarnthanarak A, Khawcharoenporn T, Thongphubeth K, et al. Postflood pseudofungemia due to Penicillium species. Clin Infect Dis. 2012;55(2):e9–e11.PubMedCrossRefGoogle Scholar
  32. 32.
    Arantes TD, Theodoro RC, Da Graca Macoris SA, Bagagli E. Detection of Paracoccidioides spp. in environmental aerosol samples. Med Mycol. 2013;51(1):83–92.PubMedCrossRefGoogle Scholar
  33. 33.
    Baddley JW, Winthrop KL, Patkar NM, et al. Geographic distribution of endemic fungal infections among older persons, United States. Emerg Infect Dis. 2011;17(9):1664–9.PubMedCrossRefGoogle Scholar
  34. 34.
    Hassan HA, Majid RA, Rashid NG, et al. Eosinophilic granulomatous gastrointestinal and hepatic abscesses attributable to basidiobolomycosis and fasciolias: a simultaneous emergence in Iraqi Kurdistan. BMC Infect Dis. 2013;13:91.PubMedCrossRefGoogle Scholar
  35. 35.
    Li AS, Pan WH, Wu SX, et al. Ecological surveys of the Cryptococcus species complex in China. Chin Med J (Engl). 2012;125(3):511–6.Google Scholar
  36. 36.
    Colom MF, Hagen F, Gonzalez A, et al. Ceratonia siliqua (carob) trees as natural habitat and source of infection by Cryptococcus gattii in the Mediterranean environment. Med Mycol. 2012;50(1):67–73.PubMedCrossRefGoogle Scholar
  37. 37.
    Chowdhary A, Randhawa HS, Boekhout T, Hagen F, Klaassen CH, Meis JF. Temperate climate niche for Cryptococcus gattii in Northern Europe. Emerg Infect Dis. 2012;18(1):172–4.PubMedCrossRefGoogle Scholar
  38. 38.
    Sellers B, Hall P, Cine-Gowdie S, et al. Cryptococcus gattii: an emerging fungal pathogen in the southeastern United States. Am J Med Sci. 2012;343(6):510–1.PubMedCrossRefGoogle Scholar
  39. 39.
    Marr KA. Cryptococcus gattii as an important fungal pathogen of western North America. Expert Rev Anti-Infect Ther. 2012;10(6):637–43.PubMedCrossRefGoogle Scholar
  40. 40.
    Marques-da-Silva SH, Rodrigues AM, de Hoog GS, Silveira-Gomes F, Camargo ZP. Occurrence of Paracoccidioides lutzii in the Amazon region: description of two cases. Am J Trop Med Hyg. 2012;87(4):710–4.PubMedCrossRefGoogle Scholar
  41. 41.
    de Hoog GS, van Diepeningen AD, el Mahgoub S, van de Sande WW. New species of Madurella, causative agents of black-grain mycetoma. J Clin Microbiol. 2012;50(3):988–94.PubMedCrossRefGoogle Scholar
  42. 42.
    Mhmoud NA, Ahmed SA, Fahal AH, de Hoog GS, Gerrits van den Ende AH, van de Sande WW. Pleurostomophora ochracea, a novel agent of human eumycetoma with yellow grains. J Clin Microbiol. 2012;50(9):2987–94.PubMedCrossRefGoogle Scholar
  43. 43.
    Harris J, Lockhart S, Chiller T. Cryptococcus gattii: where do we go from here? Med Mycol. 2012;50(2):113–29.PubMedCrossRefGoogle Scholar
  44. 44.
    Springer DJ, Phadke S, Billmyre B, Heitman J. Cryptococcus gattii, no longer an accidental pathogen? Curr Fungal Infect Rep. 2012;6(4):245–56.PubMedCrossRefGoogle Scholar
  45. 45.
    Raffa RB, Eltoukhy NS, Raffa KF. Implications of climate change (global warming) for the healthcare system. J Clin Pharm Ther. 2012;37(5):502–4.PubMedCrossRefGoogle Scholar
  46. 46.
    Bulterys PL, Le T, Quang VM, Nelson KE, Lloyd-Smith JO. Environmental predictors and incubation period of AIDS-associated Penicillium marneffei infection in Ho Chi Minh City, Vietnam. Clin Infect Dis. 2013;56(9):1273–9.PubMedCrossRefGoogle Scholar
  47. 47.
    Lanternier F, Dannaoui E, Morizot G, et al. A global analysis of mucormycosis in France: the RetroZygo Study (2005–2007). Clin Infect Dis. 2012;54 Suppl 1:S35–43.PubMedCrossRefGoogle Scholar
  48. 48.
    Weddle G, Gandy K, Bratcher D, Pahud B, Jackson MA. Apophysomyces trapeziformis infection associated with a tornado-related injury. Pediatr Infect Dis J. 2012;31(6):640–2.PubMedCrossRefGoogle Scholar
  49. 49.
    Angelini A, Drago G, Ruggieri P. Post-tsunami primary Scedosporium apiospermum osteomyelitis of the knee in an immunocompetent patient. Int J Infect Dis. 2013;17(8):e646–9.PubMedCrossRefGoogle Scholar
  50. 50.
    Oliveira GG, Navarro IT, Freire RL, et al. Serological survey of Paracoccidioidomycosis in sheep. Mycopathologia. 2012;173(1):63–8.PubMedCrossRefGoogle Scholar
  51. 51.
    • Ngamskulrungroj P, Chang Y, Sionov E, Kwon-Chung KJ. The primary target organ of Cryptococcus gattii is different from that of Cryptococcus neoformans in a murine model. MBio. 2012;3(3). Provides important insights in the pathogenesis of C. neoformans and C. gattii.Google Scholar
  52. 52.
    Trivedi SR, Sykes JE, Cannon MS, et al. Clinical features and epidemiology of cryptococcosis in cats and dogs in California: 93 cases (1988–2010). J Am Vet Med Assoc. 2011;239(3):357–69.PubMedCrossRefGoogle Scholar
  53. 53.
    • McClelland EE, Hobbs LM, Rivera J, et al. The role of host gender in the pathogenesis of Cryptococcus neoformans infections. PLoS One. 2013;8(5):e63632. With reference 34, two interesting studies exploring the mechanisms of cryptococcal disease.PubMedCrossRefGoogle Scholar
  54. 54.
    Bratton EW, El Husseini N, Chastain CA, et al. Comparison and temporal trends of three groups with cryptococcosis: HIV-infected, solid organ transplant, and HIV-negative/non-transplant. PLoS One. 2012;7(8):e43582.PubMedCrossRefGoogle Scholar
  55. 55.
    Fierer J, Burton DW, Haghighi P, Deftos LJ. Hypercalcemia in disseminated coccidioidomycosis: expression of parathyroid hormone-related peptide is characteristic of granulomatous inflammation. Clin Infect Dis. 2012;55(7):e61–6.PubMedCrossRefGoogle Scholar
  56. 56.
    Abreu e Silva MA, Salum FG, Figueiredo MA, Cherubini K. Important aspects of oral paracoccidioidomycosis – a literature review. Mycoses. 2013;56(3):189–99.PubMedCrossRefGoogle Scholar
  57. 57.
    Azenha MR, Caliento R, Brentegani LG, de Lacerda SA. A retrospective study of oral manifestations in patients with paracoccidioidomycosis. Braz Dent J. 2012;23(6):753–7.PubMedCrossRefGoogle Scholar
  58. 58.
    de Abreu ESMA, Salum FG, Figueiredo MA, Lopes TG, da Silva VD, Cherubini K. Interrelationship of clinical, histomorphometric and immunohistochemical features of oral lesions in chronic paracoccidioidomycosis. J Oral Pathol Med. 2013;42(3):235–42.CrossRefGoogle Scholar
  59. 59.
    Agudelo CA, Restrepo CA, Molina DA, et al. Tuberculosis and histoplasmosis co-infection in AIDS patients. Am J Trop Med Hyg. 2012;87(6):1094–8.PubMedCrossRefGoogle Scholar
  60. 60.
    Shahani L. Disseminated histoplasma and CMV infection presenting as subacute intestinal obstruction in an immunocompromised patient. BMJ Case Rep. 2012;2012.Google Scholar
  61. 61.
    Lee PP, Chan KW, Lee TL, et al. Penicilliosis in children without HIV infection – are they immunodeficient? Clin Infect Dis. 2012;54(2):e8–e19.PubMedCrossRefGoogle Scholar
  62. 62.
    Geramizadeh B, Foroughi R, Keshtkar-Jahromi M, Malek-Hosseini SA, Alborzi A. Gastrointestinal basidiobolomycosis, an emerging infection in the immunocompetent host: a report of 14 patients. J Med Microbiol. 2012;61(Pt 12):1770–4.PubMedCrossRefGoogle Scholar
  63. 63.
    Brick KE, Drolet BA, Lyon VB, Galbraith SS. Cutaneous and disseminated blastomycosis: a pediatric case series. Pediatr Dermatol. 2013;30(1):23–8.PubMedCrossRefGoogle Scholar
  64. 64.
    Sidamonidze K, Peck MK, Perez M, et al. Real-time PCR assay for identification of Blastomyces dermatitidis in culture and in tissue. J Clin Microbiol. 2012;50(5):1783–6.PubMedCrossRefGoogle Scholar
  65. 65.
    Van Der Veer J, Lewis RJ, Emtiazjoo AM, Allen SD, Wheat LJ, Hage CA. Cross-reactivity in the Platelia aspergillus enzyme immunoassay caused by blastomycosis. Med Mycol. 2012;50(4):396–8.CrossRefGoogle Scholar
  66. 66.
    Thompson 3rd GR, Bays DJ, Johnson SM, Cohen SH, Pappagianis D, Finkelman MA. Serum (1->3)-beta-D-glucan measurement in coccidioidomycosis. J Clin Microbiol. 2012;50(9):3060–2.PubMedCrossRefGoogle Scholar
  67. 67.
    Thompson GR, Sharma S, Bays DJ, et al. Coccidioidomycosis: adenosine deaminase levels, serologic parameters, culture results, and polymerase chain reaction testing in pleural fluid. Chest. 2013;143(3):776–81.PubMedCrossRefGoogle Scholar
  68. 68.
    Espinel-Ingroff A, Aller AI, Canton E, et al. Cryptococcus neoformans-Cryptococcus gattii species complex: an international study of wild-type susceptibility endpoint distributions and epidemiological cutoff values for fluconazole, itraconazole, posaconazole, and voriconazole. Antimicrob Agents Chemother. 2012;56(11):5898–906.PubMedCrossRefGoogle Scholar
  69. 69.
    Posteraro B, Vella A, Cogliati M, et al. Matrix-assisted laser desorption ionization-time of flight mass spectrometry-based method for discrimination between molecular types of Cryptococcus neoformans and Cryptococcus gattii. J Clin Microbiol. 2012;50(7):2472–6.PubMedCrossRefGoogle Scholar
  70. 70.
    Koepsell SA, Hinrichs SH, Iwen PC. Applying a real-time PCR assay for Histoplasma capsulatum to clinically relevant formalin-fixed paraffin-embedded human tissue. J Clin Microbiol. 2012;50(10):3395–7.PubMedCrossRefGoogle Scholar
  71. 71.
    Riviere S, Denis B, Bougnoux ME, Lanternier F, Lecuit M, Lortholary O. Serum Aspergillus galactomannan for the management of disseminated histoplasmosis in AIDS. Am J Trop Med Hyg. 2012;87(2):303–5.PubMedCrossRefGoogle Scholar
  72. 72.
    Vergidis P, Walker RC, Kaul DR, et al. False-positive Aspergillus galactomannan assay in solid organ transplant recipients with histoplasmosis. Transpl Infect Dis. 2012;14(2):213–7.PubMedCrossRefGoogle Scholar
  73. 73.
    Millon L, Larosa F, Lepiller Q, et al. Quantitative polymerase chain reaction detection of circulating DNA in serum for early diagnosis of mucormycosis in immunocompromised patients. Clin Infect Dis. 2013;56(10):e95–e101.PubMedCrossRefGoogle Scholar
  74. 74.
    El Shamy ME, Fahal AH, Shakir MY, Homeida MM. New MRI grading system for the diagnosis and management of mycetoma. Trans R Soc Trop Med Hyg. 2012;106(12):738–42.PubMedCrossRefGoogle Scholar
  75. 75.
    Bertoni TA, Perenha-Viana MC, Patussi EV, Cardoso RF, Svidzinski TI. Western blotting is an efficient tool for differential diagnosis of paracoccidioidomycosis and pulmonary tuberculosis. Clin Vaccine Immunol. 2012;19(11):1887–8.PubMedCrossRefGoogle Scholar
  76. 76.
    Dias L, de Carvalho LF, Romano CC. Application of PCR in serum samples for diagnosis of paracoccidioidomycosis in the southern Bahia-Brazil. PLoS Negl Trop Dis. 2012;6(11):e1909.PubMedCrossRefGoogle Scholar
  77. 77.
    Lackner M, de Hoog GS, Verweij PE, et al. Species-specific antifungal susceptibility patterns of Scedosporium and Pseudallescheria species. Antimicrob Agents Chemother. 2012;56(5):2635–42.PubMedCrossRefGoogle Scholar
  78. 78.
    Liu X, Zhang Z, Hou B, et al. Rapid identification of Sporothrix schenckii in biopsy tissue by PCR. J Eur Acad Dermatol Venereol. 2012. doi:10.1111/jdv.12030.Google Scholar
  79. 79.
    Huang JY, Bristow B, Shafir S, Sorvillo F. Coccidioidomycosis-associated deaths, United States, 1990–2008. Emerg Infect Dis. 2012;18(11):1723–8.PubMedCrossRefGoogle Scholar
  80. 80.
    Seitz AE, Prevots DR, Holland SM. Hospitalizations associated with disseminated coccidioidomycosis, Arizona and California, USA. Emerg Infect Dis. 2012;18(9):1476–9.PubMedCrossRefGoogle Scholar
  81. 81.
    Azadeh N, Chang YH, Kusne S, et al. The impact of early and brief corticosteroids on the clinical course of primary pulmonary coccidioidomycosis. J Infect. 2013;67(2):148–55.PubMedCrossRefGoogle Scholar
  82. 82.
    Levy ER, McCarty JM, Shane AL, Weintrub PS. Treatment of pediatric refractory coccidioidomycosis with combination voriconazole and caspofungin: a retrospective case series. Clin Infect Dis. 2013;56(11):1573–8.PubMedCrossRefGoogle Scholar
  83. 83.
    Taroumian S, Knowles SL, Lisse JR, et al. Management of coccidioidomycosis in patients receiving biologic response modifiers or disease-modifying antirheumatic drugs. Arthritis Care Res (Hoboken). 2012;64(12):1903–9.CrossRefGoogle Scholar
  84. 84.
    Proia LA, Harnisch DO. Successful use of posaconazole for treatment of blastomycosis. Antimicrob Agents Chemother. 2012;56(7):4029.PubMedCrossRefGoogle Scholar
  85. 85.
    Brilhante RS, Caetano EP, Sidrim JJ, et al. Ciprofloxacin shows synergism with classical antifungals against Histoplasma capsulatum var. capsulatum and Coccidioides posadasii. Mycoses. 2013;56(3):397–401.PubMedCrossRefGoogle Scholar
  86. 86.
    Kloezen W, Meis JF, Curfs-Breuker I, Fahal AH, van de Sande WW. In vitro antifungal activity of isavuconazole against Madurella mycetomatis. Antimicrob Agents Chemother. 2012;56(11):6054–6.PubMedCrossRefGoogle Scholar
  87. 87.
    van Belkum A, Fahal AH, van de Sande WW. In vitro susceptibility of Madurella mycetomatis to posaconazole and terbinafine. Antimicrob Agents Chemother. 2011;55(4):1771–3.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Clémence Richaud
    • 1
  • David Lebeaux
    • 1
    • 3
  • Olivier Lortholary
    • 1
    • 2
  1. 1.Sorbonne Paris Cité, AP-HP, Hôpital Necker Enfants Malades, Centre d’Infectiologie Necker-Pasteur and Institut ImagineUniversité Paris DescartesParisFrance
  2. 2.Centre National de Référence Mycoses Invasives et Antifongiques, CNRS URA3012Institut PasteurParisFrance
  3. 3.Hôpital Necker Enfants Malades, Centre d’Infectiologie Necker-PasteurParis Cedex 15France

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