The trend of imported mycoses in Japan.

Pathogenic fungi that are non-native in Japan are highly virulent and present a significant health hazard to persons in the environment into which they are introduced. Little is known, however, about the precise trend of infection by imported mycoses in Japan. To clarify this issue, all available cases were collected through a search of MEDLINE and Japana Centra Revuo Medicine and analyzed. Also included in this analysis were cases not reported in the literature for which the authors provided identification of the fungi, diagnosis, or treatment. The analysis revealed that, for three diseases, the number of imported mycoses cases in Japan is much higher than previously reported: 31 cases of coccidioidomycosis, 34 cases of histoplasmosis, and 17 cases of paracoccidioidomycosis. Additionally, one case of penicilliosis marneffei was found. The most rapid increase in the incidence of these mycoses occurred from 1991 to 1995. Analysis of the patients' profiles provided the following information: (1) coccidioidomycosis infection in Japan is increasing very rapidly, (2) Japan might be an endemic area of histoplasmosis infection, (3) histoplasmosis is a potentially fatal disease; and (4) reliable serodiagnostic methods have been used only infrequently. Because of the increase of international travel and immigration, the incidence of imported mycoses in Japan is expected to continue rising, and mycoses that have never been reported in Japan, such as blastomycosis, might also be encountered in the near future. To cope with this newly emerging health problem to residents of Japan, the Japanese medical system must train its members to identify and treat mycoses.