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]
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]
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]
^ abcdCalonje, J. Eduardo; Grayson, Wayne (2020). "18. Infectious diseases of the skin". In Calonje, J. Eduardo; Brenn, Thomas; Lazar, Alexander J.; Billings, Steven D. (eds.). McKee's Pathology of the Skin, 2 Volume Set (5th ed.). Elsevier. pp. 959–960. ISBN978-0-7020-6983-3.