Advances in Histoplasmosis Diagnosis and Antifungal Susceptibility Testing

Dear Colleagues,

Histoplasmosis is increasingly recognized as a major global fungal disease, in parallel with expanding at-risk populations, advances in diagnostic approaches, and growing recognition that exposure and disease are not confined to classical endemic maps. Recent epidemiologic studies indicate its rising incidence in North America over the past decade and enhanced detection outside historically recognized regions, while genomic epidemiology continues to reveal deep a phylogeographic structure and regionally specific lineages, including evidence of high genetic diversity in the Amazon basin.

Diagnostic approaches for histoplasmosis have evolved markedly over recent years, influencing both clinical practice and implementation strategies. Antigen detection is becoming increasingly accessible through validated and emerging lateral flow assays, alongside the broader implementation of antigen-based strategies in high-burden settings. Recent studies also support the rationale for screening strategies aimed at reducing preventable mortality. These approaches are complemented by advances in PCR- and RT-qPCR-based methods, including quantitative tools that enable the assessment of fungal burden and provide prognostic insight. At the same time, metagenomic and targeted sequencing technologies are improving species- and lineage-level identification and supporting diagnosis in complex or atypical cases.

Furthermore, therapeutic guidance for histoplasmosis has evolved alongside these advancements. Updated clinical recommendations increasingly emphasize refined risk stratification and optimized amphotericin B–azole treatment strategies, with particular attention to therapeutic drug monitoring, drug–drug interactions, and the management of special populations. Real-world data and case series continue to inform the use of liposomal amphotericin B and itraconazole as standard therapies, while alternative azoles (e.g., posaconazole or isavuconazole) are considered in cases of intolerance, refractory disease, or specific clinical scenarios. In addition, the expanding antifungal pipeline, including agents with novel mechanisms of action and improved formulations, offers promising future options that warrant dedicated evaluation against Histoplasma spp.

This Special Issue will feature original research articles, reviews, and short communications addressing contemporary challenges and advances in histoplasmosis, including epidemiology and surveillance, diagnostic approaches and their implementation, clinical management and translational research spanning One Health and environmental perspectives, genomics and phylogeography, and strategies to reduce diagnostic delay and mortality

Dr. Magalie Demar
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Fungi is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

• histoplasmosis
• genomics
• antifungal therapy
• evolving epidemiology
• diagnostic approaches
• clinical management