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David Alonso, Jose Muñoz, Emilio Letang, Elisa Salvadó, Manuel Cuenca‐Estrella, Maria José Buitrago, Josep Maria Torres, Joaquim Gascón, Imported Acute Histoplasmosis With Rheumatologic Manifestations in Spanish Travelers, Journal of Travel Medicine, Volume 14, Issue 5, 1 September 2007, Pages 338–342, https://doi.org/10.1111/j.1708-8305.2007.00138.x
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Histoplasmosis is an infection that occurs when conidia of the dimorphic fungus Histoplasma capsulatum var capsulatum are inhaled into the lungs. It is the most common systemic mycosis diagnosed among European travelers returning from endemic areas of Central and South America, 1–3 and in recent years, a growing number of cases, both isolated and in clusters, have been detected in nonendemic areas such as Europe. 4–7 This rise in apparent cases of histoplasmosis is thought to be a result of increased international travel, especially tourism, cooperation, and trade. However, heightened awareness of the clinical manifestations and epidemiology of histoplasmosis by health care practitioners in these countries may have also played a part in increasing diagnosis. Published data have undoubtedly underestimated the true magnitude of this travel‐related mycosis (as well as other geographically restricted endemic mycoses such as coccidiomycosis, paracoccidioidomycosis, and penicilliosis), and many cases, especially those asymptomatic or presenting as a mild nondescript febrile illness, often go undiagnosed.