Citations

ABSTRACT Circulating galactomannan antigen detection plays an important role in the diagnosis of histoplasmosis and blastomycosis. Historically, clinical laboratories have offered separate, genus-specific antigen detection assays across different specimen types for these two dimorphic pathogens. However, given their substantial geographic overlap, similar clinical presentation, comparable treatment approaches, and well-described antigenic cross-reactivity, the clinical rationale for maintaining separate, genus-specific antigen detection assays is increasingly unclear. In this Commentary, we propose that a combined, genus-agnostic Histoplasma / Blastomyces antigen detection assay represents a practical, evidence-aligned approach for diagnostic evaluation of these endemic mycoses.

ABSTRACT The rapid pace of name changes of medically important fungi is creating challenges for clinical laboratories and clinicians involved in patient care. We describe two sources of name change which have different drivers, at the species versus the genus level. Some suggestions are made here to reduce the number of name changes. We urge taxonomists to provide diagnostic markers of taxonomic novelties. Given the instability of phylogenetic trees due to variable taxon sampling, we advocate to maintain genera at the largest possible size. Reporting of identified species in complexes or series should where possible comprise both the name of the overarching species and that of the molecular sibling, often cryptic species. Because the use of different names for the same species will be unavoidable for many years to come, an open access online database of the names of all medically important fungi, with proper nomenclatural designation and synonymy, is essential. We further recommend that while taxonomic discovery continues, the adaptation of new name changes by clinical laboratories and clinicians be reviewed routinely by a standing committee for validation and stability over time, with reference to an open access database, wherein reasons for changes are listed in a transparent way.