Fig 1.
Global geographic distribution of reported cases of emergomycosis [1, 4–7, 10–19, 28–30].
Each icon represents a single case except for Emergomyces africanus in South Africa, as indicated. Map created by Institute of Tropical Medicine, Antwerp.
Fig 2.
Potential model for exposure and pathogenesis of Emergomyces.
1) Emergomyces species exist in soil in a mold phase, from where 2) conidia are released and aerosolized. 3) Upon inhalation by humans, the conidia undergo a temperature-dependent transformation in the lungs to yeast-like cells that replicate by budding and are capable of causing pulmonary disease in susceptible individuals. 4) Yeast-like cells disseminate hematogenously in macrophages throughout the body, causing extrapulmonary disease. 5) Cutaneous disease is most frequently reported, although virtually any body site can be affected.