{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:20:05Z","timestamp":1790774405539,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T00:00:00Z","timestamp":1597708800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/www.nationalarchives.gov.uk\/doc\/open-government-licence\/version\/2\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Histoplasmosis is often described as the most common endemic mycosis in the United States, but much remains unknown about its epidemiology among the general population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted enhanced surveillance in 9 states during 2018\u20132019 by identifying cases through routine surveillance and interviewing 301 patients about their clinical features and exposures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Before being tested for histoplasmosis, 60% saw a health care provider \u22653 times, and 53% received antibacterial medication. The median time from seeking health care to diagnosis (range) was 23 (0\u2013269) days. Forty-nine percent were hospitalized, and 69% said that histoplasmosis interfered with their daily activities (median [range], 56 [2\u20133960] days). Possible exposures included handling plants (48%) and bird or bat droppings (24%); 22% reported no specific exposures. Only 15% had heard of histoplasmosis before their illness.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Histoplasmosis can be severe and prolonged. Additional educational efforts to increase public and provider awareness and reduce delays in diagnosis are needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaa343","type":"journal-article","created":{"date-parts":[[2020,8,17]],"date-time":"2020-08-17T21:50:51Z","timestamp":1597701051000},"source":"Crossref","is-referenced-by-count":35,"title":["Enhanced Surveillance for Histoplasmosis\u20149 States, 2018\u20132019"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0458-2493","authenticated-orcid":false,"given":"Kaitlin","family":"Benedict","sequence":"first","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"McCracken","sequence":"additional","affiliation":[{"name":"Michigan Department of Health and Human Services, Lansing, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Signs","sequence":"additional","affiliation":[{"name":"Michigan Department of Health and Human Services, Lansing, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malia","family":"Ireland","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, St. Paul, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Amburgey","sequence":"additional","affiliation":[{"name":"Kentucky Department for Public Health, Frankfort, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Antonio","family":"Serrano","sequence":"additional","affiliation":[{"name":"Louisiana Department of Health, Baton Rouge, Louisiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Christophe","sequence":"additional","affiliation":[{"name":"Louisiana Department of Health, Baton Rouge, Louisiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Gibbons-Burgener","sequence":"additional","affiliation":[{"name":"Wisconsin Department of Health Services, Madison, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Hallyburton","sequence":"additional","affiliation":[{"name":"Indiana State Department of Health, Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly A","family":"Warren","sequence":"additional","affiliation":[{"name":"Pennsylvania Department of Health, Wilkes-Barre, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Keyser Metobo","sequence":"additional","affiliation":[{"name":"Nebraska Department of Health and Human Services, Lincoln, Nebraska, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Racheal","family":"Odom","sequence":"additional","affiliation":[{"name":"Arkansas Department of Health, Little Rock, Arkansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R","family":"Groenewold","sequence":"additional","affiliation":[{"name":"National Institute for Occupational Safety and Health, Cincinnati Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan R","family":"Jackson","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,8,17]]},"reference":[{"key":"2020091513541107100_CIT0001","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1086\/521259","article-title":"Clinical practice guidelines for the management of patients with histoplasmosis: 2007 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